血清NLRP3、CysC、Neuritin对脊柱骨折合并脊髓神经损伤患者术后神经功能恢复的预测效能  

Predictive efficacy of serum NLRP3,CysC and Neuritin in postoperative neurological function recovery in patients with spinal fracture complicated with spinal cord nerve injury

作　　者：袁冶 王天助 陈彤 程帅 袁绍纪 YUAN Ye;WANG Tianzhu;CHEN Tong;CHENG Shuai;YUAN Shaoji(Second Department of Neurosurgery,Shandong Provincial Public Health Clinical Center,Jinan,Shandong 250031,China)

机构地区：[1]山东省公共卫生临床中心神经外二科,山东济南250031

出　　处：《国际检验医学杂志》2025年第8期915-920,共6页International Journal of Laboratory Medicine

基　　金：山东省优秀中青年科学家科研奖励基金项目(S2021SW1194)。

摘　　要：目的探讨血清核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、胱抑素C(CysC)、神经突起因子(Neuritin)对脊柱骨折合并脊髓神经损伤(SCI)患者术后神经功能恢复的预测效能。方法选取2021年7月至2023年7月该院收治的107例脊柱骨折合并SCI患者,均于治疗后随访6个月,根据术后神经功能恢复情况分为恢复良好组(76例)与恢复不良组(31例)。比较两组临床资料、血清NLRP3、CysC、Neuritin水平,分析血清NLRP3、CysC、Neuritin与Frankel分级的相关性及对术后神经功能恢复情况的影响,评价血清NLRP3、CysC、Neuritin对术后神经功能恢复情况的预测效能。结果两组受伤至激素类药物使用时间≥8 h、椎管侵占率≥50%比例、Frankel分级比较差异均有统计学意义(P<0.05);恢复不良组血清NLRP3、CysC、Neuritin水平高于恢复良好组(P<0.05);血清NLRP3、CysC、Neuritin水平在Frankel分级A级、B级、C级、D级患者中呈逐渐下降趋势(P<0.05);血清NLRP3、CysC、Neuritin与Frankel分级呈负相关(P<0.05);血清NLRP3、CysC、Neuritin是脊柱骨折合并SCI患者术后神经功能恢复的独立危险因素(P<0.05);血清NLRP3、CysC、Neuritin预测患者术后神经功能恢复的曲线下面积(AUC)分别为0.813、0.774、0.757,灵敏度分别为74.19%、77.42%、70.97%,特异度分别为82.89%、68.42%、81.58%;三者联合预测患者术后神经功能恢复的AUC为0.927,灵敏度为83.87%,特异度为85.53%,预测价值高于各项指标单独预测(P<0.05)。结论血清NLRP3、CysC、Neuritin是脊柱骨折合并SCI患者术后神经功能恢复的独立危险因素,且联合预测价值较为可靠。Objective To investigate the predictive efficacy of serum nucleotide-binding oligomeric domainlike receptor protein 3(NLRP3),cystatin C(CysC)and Neuritin in postoperative neurological function recovery in patients with spinal fracture complicated with spinal cord nerve injury(SCI).Methods A total of 107 patients with spinal fracture complicated with SCI from July 2021 to July 2023 were selected and followed up for 6 months after treatment.They were divided into good recovery group(76 cases)and poor recovery group(31 cases)according to postoperative neurological function recovery.The clinical data,serum NLRP3,CysC and Neuritin levels of the two groups were compared,and the correlation of serum NLRP3,CysC,Neuritin and Frankel grades and their effects on postoperative neurological function recovery were analyzed.The predictive efficacy of serum NLRP3,CysC and Neuritin on postoperative neurological recovery was evaluated.Results There were statistically significant differences between the two groups in the proportion of time from injury to hormone drug use≥8 h,vertebral canal encroachation rate≥50%and Frankel grade(P<0.05).The levels of NLRP3,CysC and Neuritin in poor recovery group were higher than those in good recovery group(P<0.05).Serum NLRP3,CysC and Neuritin levels were gradually decreased in Frankel grade A,B,C and D patients(P<0.05).Serum NLRP3,CysC and Neuritin were negatively correlated with Frankel grades(P<0.05).Serum NLRP3,CysC and Neuritin were independent risk factors for postoperative neurological function recovery in patients with spinal fracture complicated with SCI(P<0.05).The area under the curve(AUC)predicted by serum NLRP3,CysC and Neuritin was 0.813,0.774 and 0.757,the sensitivity was 74.19%,77.42%and 70.97%,and the specificity was 82.89%,68.42%and 81.58%,respectively.The AUC of the combined prediction of the three indexes was 0.927,the sensitivity was 83.87%,and the specificity was 85.53%,and the prediction value was significantly higher than that predicted by each index alone(P<0.05).Con

关 键 词：脊柱骨折 脊髓神经损伤 核苷酸结合寡聚化结构域样受体蛋白3 胱抑素C 神经突起因子 

分 类 号：R826.64[医药卫生—临床医学]