STUDY ON RELEVANCE BETWEEN COR, ACTH, NLRP1 AND NLRP3 EXPRESSIONS AND PROGNOSIS OF PATIENTS WITH CRANIOCEREBRAL TRAUMA

Yu Liu, MingBo Fan, Zhang Zhang, Lu Wang, Jun Li*

Neurosurgery Department of The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology

 Objective: To study the relationship between COR, ACTH, the levels of the inflammasome proteins NLRP1 and NLRP3 and the prognosis of children with craniocerebral trauma.

Methods: Sixty-two patients with acute craniocerebral trauma admitted to our hospital between March 2013 and March 2016 were selected. Severity evaluation and grouping were conducted according to GCS scoring at admission, and there were 34 cases (3 to 8 points) in the severe-extraordinary group and 28 cases (9 to 15 points) in the mild-moderate group. In addition, 30 children with non-craniocerebral injury who were admitted to and treated at our hospital were selected. COR and ACTH levels, as well as the levels of the inflammasome proteins NLRP1 and NLRP3 in the cerebrospinal fluid of patients in the three groups were recorded 24 h after trauma. Various index levels of the patients in the three groups were compared. The relationship between the various indices and the severity of trauma in children, as well as their prognosis, was evaluated.

Results: COR, ACTH and NLRP3 levels of children with craniocerebral trauma were higher than those of the control group (P<0.05); COR, ACTH and NLP3 levels of children in the severe-extraordinary group were higher than those of children in the mild-moderate group (P<0.05); there were no significant differences in NLRP1 levels between groups (P>0.05). The percentage of poor prognosis of children in the severe-extraordinary group was higher than that of the mild-moderate group (P<0.05). COR, ACTH and NLRP3 levels of children with poor prognosis were higher than those of children with good prognosis (P<0.05), but NLRP1 levels exhibited no significant differences (P>0.05). COR, ACTH and NLRP3 levels had negative correlations with GOS scoring of follow-ups and prognoses (P<0.05).

Conclusion: COR, ACTH and NLRP3 levels in children with early craniocerebral injury increase with time. The more severe the trauma, the higher are the levels. Levels of the three can be used for judging the severity and prognosis of these conditions, while NLRP1 levels have little correlation with conditions and prognosis.