外周血NLRP3、IL-18、 IL-1β与慢性阻塞性肺疾病急性加重相关

doi:10.16352/j.issn.1001-6325.2026.02.0273

基础医学与临床 ›› 2026, Vol. 46 ›› Issue (2): 273-277.doi: 10.16352/j.issn.1001-6325.2026.02.0273

外周血NLRP3、IL-18、 IL-1β与慢性阻塞性肺疾病急性加重相关

高生虎¹, 吴志飞^2*, 杨咏宝¹, 李姝¹

国药东风花果医院 1.内一科; 2.急诊科, 湖北十堰 442008

收稿日期:2024-12-30 修回日期:2025-04-30 出版日期:2026-02-05 发布日期:2026-01-21
通讯作者: ^* qiuhaitang452@163.com

Relationship between peripheral blood NLRP3, IL-18, IL-1 β and the prognosis of acute exacerbation of chronic obstructive pulmonary disease

GAO Shenghu¹, WU Zhifei^2*, YANG Yongbao¹, LI Shu¹

1. Department of Internal Medicine, 2. Emergency Department, Guoyao Dongfeng Flower and Fruit Hospital, Shiyan 442008, China

Received:2024-12-30 Revised:2025-04-30 Online:2026-02-05 Published:2026-01-21
Contact: ^* qiuhaitang452@163.com

摘要/Abstract

摘要： 目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者外周血单核细胞中NOD样受体热蛋白结构域3(NLRP3)的mRNA(NLRP3 mRNA)表达及血清白细胞介素18(IL-18)、白细胞介素1β(IL-1β)水平变化及临床意义。方法选取220例慢性阻塞性肺疾病(COPD)患者并依据病情严重程度分为稳定期组(n=122)、AECOPD组(n=98),依据预后情况将AECOPD患者分为预后不良组(n=31)、预后良好组(n=67);选取50例健康体检者为对照组。采集基线资料,RT-qPCR检测NLRP3 mRNA表达,ELISA法测定血清中IL-1β及IL-18水平,分析AECOPD预后不良的影响因素。ROC曲线分析NLRP3、IL-18及IL-1β三者预测AECOPD预后不良的效能。结果相较于对照组,稳定期组及AECOPD组NLRP3、IL-18及IL-1β水平明显增高(P＜0.05),且AECOPD组高于稳定期组(P＜0.05)。预后不良组病程、NLRP3、IL-18及IL-1β高于预后良好组(P＜0.05),FEV₁%、FEV₁/FVC低于预后良好组(P＜0.05)。病程、NLRP3、IL-18及IL-1β是AECOPD预后不良的独立危险因素。ROC结果显示,NLRP3、IL-18及IL-1β联合预测AECOPD预后不良的AUC为0.985,敏感度为0.940,特异度为0.968。结论 AECOPD患者外周血NLRP3、IL-18及IL-1β呈高表达,3者联合检测对AECOPD预后不良有较好的预测价值。

关键词: 细胞焦亡, 慢性阻塞性肺疾病急性加重期, NLRP3, IL-18, IL-1β

Abstract: Objective To investigate the expression of NLRP3 mRNA in peripheral blood mononuclear cells (PBMCs) and the serum levels of interleukin-18 (IL-18) and interleukin-1β (IL-1β), as well as their clinical significance, in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 220 patients with COPD were enrolled and divided into stable group (n=122) and AECOPD group (n=98) according to the severity of the disease. AECOPD patients were divided into poor prognosis group (n=31) and good prognosis group (n=67) according to prognosis. Fifty healthy subjects were selected as control group. Baseline data were collected, RT-qPCR was used to detect NLRP3 mRNA expression, and enzyme-linked immunosorbent assay was used to determine IL-1β and IL-18 levels. Multivariate Logistic stepwise regression model was used to analyze the prognostic factors of AECOPD. Receiver operating characteristic curve (ROC) was used to analyze the efficacy of NLRP3 mRNA, IL-18 and IL-1β in predicting the poor prognosis of AECOPD. Results Compared with the control group, the levels of NLRP3 mRNA, IL-18 and IL-1β in stable group and AECOPD group were increased (P＜0.05), and those indices of AECOPD group were higher than those in stable group (P＜0.05). The disease duration, NLRP3 mRNA, IL-18 and IL-1β of poor prognosis group were higher than those of good prognosis group (P＜0.05), and the FEV₁% and FEV₁/FVC of poor prognosis group were lower than good prognosis group(P＜0.05). The disease course, NLRP3 mRNA, IL-18 and IL-1β were risk factors affecting prognosis of AECOPD. ROC results showed that NLRP3 mRNA, IL-18 and IL-1β combined predicted the poor prognosis of AECOPD with an AUC of 0.985, a sensitivity of 0.940 and a specificity of 0.968. Conclusions The expression of NLRP3 mRNA in PBMCs and the serum levels of IL-18 and IL-1β are elevated in AECOPD patients. The combined detection of these three indicators shows good predictive value for poor prognosis in AECOPD.

Key words: cell pyroptosis, acute exacerabation of chronic obstructive pulmonary disease(AECOPD), IL-18, NLRP3, IL-1β

中图分类号:

R563

高生虎, 吴志飞, 杨咏宝, 李姝. 外周血NLRP3、IL-18、 IL-1β与慢性阻塞性肺疾病急性加重相关[J]. 基础医学与临床, 2026, 46(2): 273-277.

GAO Shenghu, WU Zhifei, YANG Yongbao, LI Shu. Relationship between peripheral blood NLRP3, IL-18, IL-1 β and the prognosis of acute exacerbation of chronic obstructive pulmonary disease[J]. Basic & Clinical Medicine, 2026, 46(2): 273-277.

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外周血NLRP3、IL-18、 IL-1β与慢性阻塞性肺疾病急性加重相关

Relationship between peripheral blood NLRP3, IL-18, IL-1 β and the prognosis of acute exacerbation of chronic obstructive pulmonary disease

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