血清NLRP3、NLRC4水平对高血压基底节区脑出血术后近期预后的预测价值OA

Objective To investigate the predictive value of serum NOD-like receptor thermal protein domain asso-ciated protein 3(NLRP3)and NOD-like receptor family CARD domain containing 4(NLRC4)levels for short-term prognosis after surgery in patients with hypertensive basal ganglia intracerebral hemorrhage(HBGH).Methods A total of 182 HBGH patients(HBGH group)who underwent minimally invasive hematoma evacuation in the Department of Neurosurgery,Yulin First Hospital,from January 2022 to May 2025,and 125 healthy controls(healthy control group)during the same period were enrolled.Serum levels of NLRP3 and NLRC4 were measured by enzyme-linked immunosorbent assay.Based on disease se-verity,HBGH patients were categorized into mild(n=34),moderate(n=45),moderately severe(n=47),and severe(n=56)subgroups.The correlation between serum NLRP3,NLRC4 levels and disease severity was analyzed using Spearman correla-tion.According to 3-month prognosis,HBGH patients were divided into poor prognosis and good prognosis subgroups.Multi-variate logistic regression analysis was used to identify factors influencing short-term postoperative poor prognosis;ROC curve analysis was employed to assess the value of serum NLRP3 and NLRC4 levels in predicting short-term postoperative poor prognosis.Results Serum NLRP3 and NLRC4 levels were significantly higher in the HBGH group than in the healthy con-trol group(t/P=21.239/＜0.001,16.528/＜0.001).Serum NLRP3 and NLRC4 levels increased progressively across the mild,moderate,moderately severe,and severe HBGH subgroups(F/P=396.166/＜0.001,487.216/＜0.001).A positive correlation was observed between serum NLRP3,NLRC4 levels and disease severity in HBGH patients(rs/P=0.826/＜0.001,0.878/＜0.001).The poor prognosis rate among the 182 HBGH patients was 33.52％(61/182).NLRP3 and NLRC4 levels were significantly higher in the poor prognosis subgroup than in the good prognosis subgroup(t/P=7.020/＜0.001,7.727/＜0.001).Severe HBGH,larger hematoma volume,elevated NLRP3,and elevated NLRC4 were identified as independent risk factors for short-term postoperative poor prognosis,while higher Glasgow Coma Scale(GCS)score was an independent protective factor[OR(95％CI)=13.097(2.009-85.400),1.128(1.057-1.203),3.027(1.648-5.561),1.080(1.039-1.123),0.646(0.529-0.790)].The AUCs for serum NLRP3 level,NLRC4 level,and their combination in predicting short-term postoperative poor prognosis were 0.781,0.793,and 0.860,respectively.The combined predictive value was superior to that of either biomarker alone(Z/P=2.914/0.004,2.736/0.006).Conclusion Elevated serum NLRP3 and NLRC4 levels in HBGH patients are associated with in-creased disease severity and short-term postoperative poor prognosis.The combination of these two biomarkers demonstrates high predictive value for short-term postoperative prognosis in HBGH patients.