目的 探究脑出血患者脑组织中Nod样受体蛋白-3(NLRP3)、NIMA相关蛋白激酶7(NEK7)表达水平与疾病严重程度的相关性.方法 前瞻性选取2017年1月至2020年12月郑州颐和医院诊治的80例脑出血患者进行研究,取皮层造瘘通道靠近血肿0.5 cm处的脑组织为靠近组,另取远离血肿位置的脑组织为远离组.依据脑出血患者出血量将其分为少量组(出血量<15 mL)29例、中量组(出血量15~30 mL)27例和大量组(出血量>30 mL)24例;按美国国立卫生研究院卒中量表(NIHSS)评分将患者分为轻型组(1~4分)30例、中型组(5~15分)27例和重型组(>15分)23例.采用实时荧光定量PCR(qRT-PCR)法测定各组脑组织中NEK7 mRNA、NLRP3 mRNA表达水平;采用Pearson法分析脑出血患者血肿0.5 cm处脑组织中NEK7 mRNA表达水平与NLRP3 mRNA表达水平的相关性;比较不同出血量、不同严重程度的脑出血患者距离血肿0.5 cm处脑组织中NEK7 mRNA、NLRP3 mRNA表达水平.结果 靠近组患者脑组织中NEK7 mRNA、NLRP3 mRNA表达水平分别为1.72±0.58、1.69±0.57,明显高于远离组的1.03±0.34、1.01±0.33,差异均有统计学意义(P<0.05);脑出血患者血肿0.5 cm处脑组织中NEK7 mRNA表达水平与NLRP3 mRNA表达水平呈正相关(r=0.563,P<0.05);脑出血患者距离血肿 0.5 cm处脑组织中NEK7 mRNA、NLRP3 mRNA表达水平随着出血量的增加而升高,差异均有统计学意义(P<0.05);脑出血患者距离血肿0.5 cm处脑组织中NEK7 mRNA、NLRP3 mRNA表达水平随着NIHSS评分的增加而升高,差异均有统计学意义(P<0.05).结论 脑出血患者距离血肿0.5 cm处脑组织中NEK7、NLRP3表达水平明显升高,两者均与出血量和疾病严重程度显著相关,检测距离血肿0.5 cm处脑组织NEK7、NLRP3有利于判断脑出血严重程度及出血情况.
Objective To explore the correlation between the expression levels of Nod-like receptor pyrin do-main 3(NLRP3)and NIMA-related kinase 7(NEK7)and the severity of cerebral hemorrhage.Methods Eighty pa-tients with cerebral hemorrhage treated in Zhengzhou Yihe Hospital from January 2017 to December 2020 were selected for a prospective study.The cerebral tissues of the corticostomy channel at 0.5 cm near the hematoma were selected as the near group,and those far away from the hematoma were selected as the distant group.According to the amount of bleeding,the patients were divided into small amount group(bleeding<15 mL,29 cases),medium amount group(bleed-ing 15-30 mL,27 cases),and large amount group(bleeding>30 mL,24 cases).According to National Institutes of Health Stroke Scale(NIHSS)score,the patients were divided into mild group(1-4 points,30 cases),moderate group(5-15 points,27 cases),and severe group(>15 points,23 cases).The expression levels of NEK7 mRNA and NLRP3 mRNA in brain tis-sue were determined by real-time fluorescent quantitative PCR(qRT-PCR).The correlation between NEK7 mRNA expres-sion and NLRP3 mRNA expression in the brain tissue at 0.5 cm near the hematoma was detected by Pearson method.The expression levels of NEK7 mRNA and NLRP3 mRNA in the brain tissue at 0.5 cm near the hematoma of patients with dif-ferent amount of bleeding and different severity of intracerebral hemorrhage were compared.Results The expression levels of NEK7 mRNA and NLRP3 mRNA in the brain tissues of the near group were 1.72±0.58 and 1.69±0.57,re-spectively,which were significantly higher than 1.03±0.34 and 1.01±0.33 of the distant group(P<0.05).There was a pos-itive correlation between NEK7 mRNA expression level and NLRP3 mRNA expression level in the brain tissue at 0.5 cm near the hematoma in patients with cerebral hemorrhage(r=0.563,P<0.05).The expression levels of NEK7 mRNA and NLRP3 mRNA in the brain tissue at 0.5 cm near the hematoma in patients with cerebral hemorrhage increased with the increase of blood loss,and the differences were statistically significant(P<0.05).The expression levels of NEK7 mRNA and NLRP3 mRNA in the brain tissue at 0.5 cm near the hematoma in patients with cerebral hemorrhage in-creased with the increase of NIHSS score,and the differences were statistically significant(P<0.05).Conclusion The expression levels of NEK7 and NLRP3 in the brain tissue at 0.5 cm near the hematoma of patients with intracerebral hemorrhage are significantly increased,and both of them are significantly correlated with amount of bleeding and dis-ease severity.The detection of NEK7 and NLRP3 in the brain tissue at 0.5 cm near the hematoma is helpful to judge the severity and condition of cerebral hemorrhage.