Associations of serum NLRP3, ASC, caspase-1 with the outcome in patients with hypertensive intracerebral hemorrhage after minimally invasive neuroendoscopic surgery
10.3760/cma.j.issn.1673-4165.2025.04.004
- VernacularTitle:血清NLRP3、ASC、胱天蛋白酶-1与高血压性脑出血患者微创神经内镜手术后转归的相关性
- Author:
Laifu ZHAO
1
;
Jianlong ZHANG
;
Huifeng LI
Author Information
1. 陆军军医大学士官学校附属医院神经外科，石家庄 050000
- Keywords:
Cerebral hemorrhage;
Intracranial hemorrhage, hypertensive;
Neuroendoscopy;
NLR family, pyrin domain-containing 3 protein;
Inflammasomes;
CARD signaling ad
- From:
International Journal of Cerebrovascular Diseases
2025;33(4):260-265
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate associations of serum nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3), apoptosis-associated speck like protein containing a caspase recruitment domain (ASC), caspase-1 with the outcome in patients with hypertensive intracerebral hemorrhage (HICH) after minimally invasive neuroendoscopic surgery.Methods:Patients with HICH underwent minimally invasive neuroendoscopic surgery at the Affiliated Hospital of Noncommissioned Officer School, Army Medical University between June 2022 and June 2024 were included prospectively. According to the Glasgow Outcome Scale score at 3 months after surgery, the patients were divided into a good outcome group (4-5) and a poor outcome group (1-3). The clinical data and peripheral blood levels of NLRP3, ASC, caspase-1, interleukin (IL)-18, and IL-1β between the two groups were compared. Multivariate logistic regression analysis was used to determine assocations of serum NLRP3, ASC, caspase-1 with the postoperative outcome. Results:A total of 121 patients with HICH were enrolled, including 71 males (58.68), aged 56.11±4.96 years. At 3 months after surgery, 70 patients (57.9%) had good outcome, 51 (42.1%) had poor outcome, and 3 died. Onset to admission time, onset to first CT scan time, onset to surgery time, baseline serum NLRP3, ASC, caspase-1, baseline hematoma volume, and the proportion of patients with hematoma rupture into the ventricles and midline shift in the poor outcome group were significantly higher than those in the good outcome group, while baseline Glasgow Coma Scale (GCS) score and hematoma clearance rate were significantly lower than those in the good outcome group ( P<0.05). Multivariate logistic regression analysis showed that after adjusting for other factors such as onset to surgery time, baseline GCS score, hematoma rupture into the ventricles, and hematoma clearance rate, baseline serum NLRP3 (odds ratio [ OR] 2.018, 95% confidence interval [ CI] 1.502-2.711; P<0.001), ASC [ OR 1.764, 95% CI 1.418-2.195; P<0.001], caspase-1 [ OR 1.901, 95% CI 1.476-2.449; P<0.001]) were significantly independently associated with the poor outcome. Conclusion:The serum levels of NLRP3, ASC, and caspase-1 are significantly higher in HICH patients with poor outcome, and are independently associated with the poor outcome after minimally invasive neuroendoscopic surgery.
