外周血NLRP3、NF-κB预测AMI患者PCI术后冠状动脉无复流的临床价值OA

Objective To explore the clinical value of peripheral blood nucleotide-binding oligomerization domain-like receptor family protein 3(NLRP3)and nuclear factor-kappa B(NF-κB)in predicting coronary no-reflow after percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocar-dial infarction(STEMI).Methods A total of 216 patients with STEMI in the hospital from January 2023 to June 2024 were selected prospectively as the research subjects,which were divided into the no-reflow group and the reflow group according to the thrombolysis in myocardial infarction(TIMI)flow grading criteria after PCI.Baseline data of the patients were collected.Serum levels of NLRP3 and NF-κB were measured before surgery,immediately after surgery,and 24 h after surgery.Pearson correlation analysis was used to analyze the correlation between the Gensini score and serum NLRP3,NF-κB levels at different time points in patients with STEMI.Multivariate Logistic regression analysis was performed to analyze the factors influencing coronary no-reflow after PCI in STEMI patients.Receiver operating characteristic(ROC)curve was plotted to evaluate the diagnostic efficacy of serum NLRP3 and NF-κB at different time points in predicting coronary no-reflow after PCI.Results According to the postoperative TIMI blood flow grading criteria,patients are divided into the no-reflow group(69 cases)and the reflow group(147 cases).The pre-operative Gensini score in the no-re-flow group is obviously higher than that in the reflow group(P<0.05).The results of the repeated measures analysis of variance showed that there were significant differences in the between-group effect,time effect,and interaction effect of serum NLRP3 and NF-κB between the two groups(P<0.05).The serum levels of NL-RP3 and NF-κB before surgery,immediately after surgery,and 24 h after surgery in the no-reflow group were significantly higher than those in the reflow group(P<0.05).In both groups,the serum levels of NLRP3 and NF-κB 24 h after surgery and immediately after surgery were significantly lower than those before surgery,and the serum levels of NLRP3 and NF-κB 24 h after surgery were significantly higher than those immediately after surgery,with statistically significant differences(P<0.05).The results of Pearson correlation analysis showed that the Gensini score of STEMI patients was positively correlated with the serum levels of NLRP3 and NF-κB at different time points(P<0.05).The results of multivariate Logistic regression analysis showed that the elevated levels of NLRP3 and NF-κB in the serum at all time points were the risk factors for the oc-currence of coronary no-reflow in patients after PCI(P<0.05).The results of ROC curve analysis showed that the areas under the curves(AUCs)of serum NLRP3 and NF-κB alone in predicting coronary no-reflow after PCI at different time points were all>0.5,and the AUC of the combined regression model of serum NL-RP3 and NF-κB at different time points in predicting coronary no-reflow after PCI was significantly larger than that of each indicator alone at different time points(P<0.05).Conclusion Serum NLRP3 and NF-κB levels are abnormally elevated in patients with coronary no-reflow after PCI,and both of them are closely associated with disease severity.They can be used to predict the occurrence of coronary no-reflow in patients after PCI,which is worthy of clinical application.