Department of Neurology, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei, China.
Contrast Media Mol Imaging. 2022 Aug 16;2022:3464042. doi: 10.1155/2022/3464042. eCollection 2022.
The aim of this study was to investigate imaging features of magnetic resonance imaging (MRI), pathological features of thrombus, and expression of nucleotide-binding oligomerization domain-like receptors protein 3 (NLRP3) inflammasome in acute ischemic stroke (AIS). Their relationship with the prognosis of patients was also explored. Sixty patients with AIS admitted to the hospital were selected as the observation group, and 20 healthy objects were in the control group. The shape of the thrombus was observed by MRI, pathological features of the thrombus were observed under hematoxylin-eosin (HE) staining, and the levels of NLRP3 inflammasome and inflammatory factors in serum were detected. The MRI-T2 weighted imaging (T2WI) signal ratio and plaque enhancement rate in the observation group were higher than those in the control group significantly ( < 0.05). In the observation group, the red/mixed thrombus in 6-12 h and 24 h were also much higher than that in 6 h ( < 0.05). The levels of NLRP3, interleukin-1 (IL-1), interleukin-18 (IL-18), and tumor necrosis factor- (TNF-) in the observation group were higher than those in the control group in 6 h, 6-12 h, and 24 h ( < 0.05), and those reached the highest levels in 24 h. The ratio of fibrins/platelets in the cardiogenic thrombus reached (63.8 ± 15.6) %, which was significantly higher than that in the large-artery atherosclerotic thrombus (49.5 ± 14.2) %, < 0.05. The ratio of red blood cells (RBCs) in the large atherosclerotic thrombus was (30.7 ± 14.3) %, considerably lower than (42.9 ± 15.2) %, < 0.05. The prognosis of patients with the fibrin/platelet-rich thrombus was highly lower than that with the RBC-rich thrombus ( < 0.05). The levels with poor prognosis were higher than those with good prognosis ( < 0.05). MRI could be used to assist in the assessment of brain conditions in patients with AIS. NLRP3 inflammasome was involved in the inflammatory response of AIS and can be used for predicting the poor prognosis, having a certain clinical application value. In addition, different types of thrombi also laid a certain impact on prognosis.
本研究旨在探讨磁共振成像（MRI）的影像学特征、血栓的病理特征以及核苷酸结合寡聚化结构域样受体蛋白 3（NLRP3）炎性小体在急性缺血性脑卒中（AIS）中的表达。还探讨了它们与患者预后的关系。选取我院收治的 60 例 AIS 患者为观察组，20 例健康对象为对照组。观察 MRI 下血栓形态，苏木精-伊红（HE）染色观察血栓病理特征，检测血清 NLRP3 炎性小体及炎症因子水平。观察组 MRI-T2 加权成像（T2WI）信号比值及斑块增强率明显高于对照组（ < 0.05）。观察组 6-12 h 和 24 h 红/混合血栓也明显高于 6 h（ < 0.05）。观察组在 6 h、6-12 h 和 24 h 时 NLRP3、白细胞介素-1（IL-1）、白细胞介素-18（IL-18）和肿瘤坏死因子-（TNF-）水平均高于对照组（ < 0.05），且在 24 h 时达到最高水平。心源性血栓中的纤维蛋白/血小板比值达到（63.8±15.6）%，明显高于大动脉粥样硬化性血栓中的（49.5±14.2）%（ < 0.05）。大动脉粥样硬化性血栓中红细胞（RBC）的比值为（30.7±14.3）%，明显低于（42.9±15.2）%（ < 0.05）。纤维蛋白/血小板丰富的血栓患者的预后明显低于 RBC 丰富的血栓患者（ < 0.05）。预后不良者的水平高于预后良好者（ < 0.05）。MRI 可用于辅助评估 AIS 患者的脑状况。NLRP3 炎性小体参与 AIS 的炎症反应，可用于预测不良预后，具有一定的临床应用价值。此外，不同类型的血栓也对预后产生一定影响。
