摘要目的:探讨炎性体蛋白嗜中性白细胞碱性磷酸酶-1(NALP-1)在创伤性脑损伤患者脑脊液中表达水平及其与预后相关性。方法:选取2017年2月至2018年9月来自首都医科大学附属北京同仁医院的120例创伤性脑损伤患者，选取同期健康体检者30例作为对照组，采用免疫印迹化学发光法检测研究对象脑脊液中炎性体蛋白NALP-1表达水平，根据格拉斯哥预后评分(GOS)将创伤性脑损伤患者分为预后良好组(GOS>3分)和预后不良组(GOS≤3分)。 χ2检验和 t检验分析预后良好组和预后不良组NALP-1和临床资料差异，采用多因素Logistic回归模型分析创伤性脑损伤后患者预后影响因素。 结果:创伤性脑损伤患者脑脊液中NALP-1表达(1.64±0.52)高于对照组(0.94±0.28， t＝7.108， P<0.05)，差异有统计学意义。NALP-1高表达组急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)得分(26.4±5.4)分、脑挫伤比例(76.62%)、蛛网膜下腔出血比例(77.27%)高于低表达组[(22.3±4.5)分、23.38%、22.73%]，差异有统计学意义( χ2/ t＝4.135、9.586、7.424， P<0.05)。年龄[比值比( OR)：2.175，95%可信区间( CI)：1.167～8.767， P<0.05]、蛛网膜下腔出血( OR：1.241，95% CI：1.101～3.794， P<0.05)、NALP-1( OR：2.841，95% CI：1.675～10.717， P<0.05)、纤维蛋白原水平( OR：1.215，95% CI：1.056～3.627， P<0.05)、APACHE Ⅱ得分( OR：1.615，95% CI：1.314～5.485， P<0.05)是预后不良独立影响因素，差异均有统计学意义。 结论:创伤性脑损伤脑脊液中NALP-1表达增加，且表达量升高与预后不良相关。

abstractsObjective:To investigate the expression level of inflammatory body protein neutrophil alkaline phosphatase-1 (NALP-1) in cerebrospinal fluid of patients with traumatic brain injury and its correlation with prognosis.Methods:Totally 120 patients with traumatic brain injury and 30 healthy subjects in the same period (the control group) were selected. The level of NALP-1 was detected by immunoblotting chemiluminescence method. According to the Glasgow Outcome Score (GOS), patients with traumatic brain injury were divided into a good prognosis group (GOS>3 points) and a poor prognosis group (GOS≤3 points). The correlation between NALP-1 levels in cerebrospinal fluid and prognosis was analyzed.Results:The relative expression of NALP-1 in cerebrospinal fluid (1.64±0.52) was higher in patients with traumatic brain injury than in the control group (0.94±0.28, t=7.108, P<0.05). In the NALP-1 high expression group, Acute Physiology and Chronic Health Evaluation (APACHEⅡ) score (26.4±5.4), brain contusion rate (76.62%), and subarachnoid hemorrhage rate (77.27%) were higher than in the low NALP-1 expression group [(22.3±4.5) score, 23.38%, 22.73%], and the difference was statistically significant ( χ2/ t=4.135, 9.586, 7.424, P<0.05). The multivariate analysis showed that age [odds ratio ( OR): 2.1.775, 95% confidence interval ( CI): 1.167-8.767, P<0.05], subretinal hemorrhage ( OR: 1.241, 95% CI: 1.101-3.794, P<0.05), relative expression of NALP-1 ( OR: 2.841, 95% CI: 1.675-10.717, P<0.05), fibrinogen levels ( OR: 1.215, 95% CI: 1.056-3.627, P<0.05), and APACHE Ⅱ score ( OR: 1.615, 95% CI: 1.314-5.485, P<0.05) were independent influencing factors for poor prognosis. Conclusion:The expression of NALP-1 in cerebrospinal fluid of traumatic brain injury is increased, which is associated with poor prognosis.