分析NOD样受体热蛋白结构域相关蛋白3(NOD-like receptor thermal protein domain associated protein 3, NLRP3)信号通路及相关细胞因子预测老年重症肺炎患者预后不良的因素。

选择2021年6月至2025年6月我院收治的老年重症肺炎患者100例，根据患者预后情况，生存者为对照组63例和死亡者为观察组37例。比较两者基线资料、NLRP3信号通路及相关细胞因子水平，多因素Logistic回归分析老年重症肺炎患者预后不良的危险因素，采取工作特征曲线(receiver operating characteristic, ROC)分析肺炎严重指数(pneumonia severity index, PSI)评分及NLRP3信号通路及相关细胞因子预测老年重症肺炎患者预后不良的意义。

观察组机械通气时间(10.42±1.37)d、ICU住院天数(14.35±2.08)d、PSI评分(92.33±20.28)分、NLRP3 (3.34±1.25)、Caspase-1(3.06±1.12)、IL-1β(56.73±12.25)pg/ml水平高于生存者(6.24±1.04)d、(12.74±2.13)d、(80.18±14.78)分、(2.73±0.64)、(2.54±0.33)、(49.12±10.56)pg/ml(P<0.05)；经多因素Logistic回归分析证实，机械通气时间较长、PSI评分、NLRP3、Caspase-1、IL-1β水平是老年重症肺炎患者预后不良的危险因素(P<0.05)；经ROC分析证实PSI评分、NLRP3、Caspase-1、IL-1β水平均可用于预测老年重症肺炎患者预后不良风险，曲线下面积分别为0.678、0.825、0.744、0.749，联合预测可获得高曲线下面积为0.966(P<0.05)。

NLRP3信号通路及相关细胞因子水平与老年重症肺炎患者预后不良风险关系密切，联合PSI评分可进一步提高重症肺炎临床预测意义。

Sample analysis NOD heat receptor protein structure domain related protein 3 (NLRP3) signaling pathways and related cell factors to predict the value of the death of elderly patients with severe pneumonia was.

The clinical data of 100 elderly patients with severe pneumonia treated in our hospital from June 2021 to June 2024 were prospectively analyzed, and the patients were divided into survival group and death group according to whether they survived for 28 days. The baseline data, NLRP3 signaling pathway and related cytokine levels of the two groups were compared.Multiariable Logistic regression analysis of the risk factors of death of elderly patients with severe pneumonia was taken ROC analysis was used to analyze the value of pneumonia severity index (PSI) score, NLRP3 signaling pathway and related cytokines in predicting the death of elderly patients with severe pneumonia.

37 of 100 elderly patients with severe pneumonia died, the mortality rate was 37%. 63 patients were discharged successfully after treatment, and the survival rate was 63%. The mechanical ventilation time, ICU stay days, PSI score, NLRP3, Caspase-1 and IL-1β levels in death group were higher than those in survival group (P<0.05); Multiple Logistic regression analysis confirmed that longer mechanical ventilation time, PSI score, NLRP3, Caspase-1, IL-1β levels were risk factors for death in elderly patients with severe pneumonia was both (P<0.05); Confirmed by ROC analysis PSI score, NLRP3, Caspase 1, the level of IL-1 beta can be used to predict mortality risk of elderly patients with severe pneumonia was, the area under the curve were 0.678, 0.825, 0.744, 0.749, And the above factors combined prediction can be obtained under higher curve area is 0.966, both(P<0.05).

NLRP3 signaling pathways and related cytokine levels and risk of death of elderly patients with severe pneumonia was closely related to, joint PSI grading test can further improve the predictive value.