摘要
目的检测脑梗死继发癫痫患者的血清神经调节蛋白1(NRG1)、视锥蛋白样蛋白-1(VILIP-1)水平并探讨其临床意义。方法选取2019年1月至2023年4月期间安阳市第三人民医院收治的100例脑梗死继发癫痫患者作为研究组,并依照发病时间分为早发型癫痫组(n=53)和晚发型癫痫组(n=47)。选取同期脑梗死未继发癫痫患者60例作为对照组。比较早发型癫痫组和晚发型癫痫组患者的血清NRG1、VILIP-1水平以及研究组和对照组患者的临床资料,采用Pearson相关分析血清NRG1与VILIP-1的关系,采用多因素Logistic回归分析脑梗死继发癫痫的影响因素,绘制受试者工作特征曲线(ROC)分析NRG1、VILIP-1对脑梗死继发癫痫的预测价值。结果早发型癫痫患者的血清NRG1、VILIP-1水平分别为(23.72±3.47)pg/mL、(627.49±72.29)pg/mL,明显高于晚发型癫痫的(20.38±3.60)pg/mL、(572.52±61.49)pg/mL,差异均有统计学意义(P<0.05);研究组患者入院时的美国国立卫生研究院卒中量表(NIHSS)评分、血清神经元特异性烯醇化酶(NSE)、NRG1、VILIP-1、同型半胱氨酸(Hcy)水平分别为(12.58±2.86)分、(8.87±1.54)k U/L、(22.15±3.53)pg/mL、(601.65±67.21)pg/mL、(31.53±4.08)μmol/L,明显高于对照组的(11.66±2.12)分、(7.76±1.67)k U/L、(18.72±2.83)pg/mL、(542.74±61.71)pg/mL、(31.53±4.08)μmol/L,而脑源性神经生长因子(BDNF)为(4.18±0.89)μg/mL,明显低于对照组的(5.02±1.10)μg/mL,差异均有统计学意义(P<0.05);Pearson相关分析结果显示,血清NRG1与VILIP-1表达水平呈正相关(r=0.553,P<0.05);多因素Logistic回归分析结果显示,NSE、NRG1、VILIP-1、Hcy均是脑梗死继发癫痫的危险因素(P<0.05),BDNF是脑梗死继发癫痫的保护因素(P<0.05);ROC分析结果显示,血清NRG1、VILIP-1预测脑梗死继发癫痫的AUC分别为0.844、0.768,NRG1联合VILIP-1预测的AUC为0.883,两者联合预测脑梗死继发癫痫的AUC优于NRG1(Z_(两者联合-NRG1)=2.058)、VILIP-1(Z_(两者联合-VILIP-1)=3.820)单独指标(P<0.05)。结论脑梗死继发癫痫患者血清NRG1、VILIP-1水平异常高表达,是患者脑梗死后继发癫痫的危险因素,两者联合检测对预测脑梗死后继发癫痫具有较高的临床价值。
Objective To detect serum neuregulin 1(NRG1)and visinin like protein 1(VILIP-1)levels in patients with epilepsy secondary to cerebral infarction and to investigate their clinical significance.Methods A total of 100 patients with epilepsy secondary to cerebral infarction admitted to Anyang Third People's Hospital from January 2019 to April 2023 were selected as the study group,which were grouped into early onset epilepsy group(n=53)and late onset epilepsy group(n=47)according to the onset time.Sixty patients with cerebral infarction but no secondary epilepsy during the same period were regarded as the control group.The serum NRG1 and VILIP-1 levels were compared between patients in the early onset epilepsy group and late onset epilepsy group,and the clinical data were compared between the patients in the study group and control group.The correlation between serum NRG1 and VILIP-1 was analyzed by Pearson correlation analysis.Multifactorial Logistic regression was applied to analyze the influencing factors of epilepsy secondary to cerebral infarction.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of NRG1 and VILIP-1 for epilepsy secondary to cerebral infarction.Results Serum NRG1 and VILIP-1 levels in patients with early onset epilepsy were(23.72±3.47)pg/mL and(627.49±72.29)pg/mL,respectively,which were significantly higher than(20.38±3.60)pg/mL and(572.52±61.49)pg/mL in patients with late onset epilepsy(P<0.05).The National Institutes of Health Stroke Scale(NIHSS)score,serum neuron specific eno1ase(NSE),NRG1,VILIP-1,and homocysteine(Hcy)levels at admission in the study group were(12.58±2.86)points,(8.87±1.54)kU/L,(22.15±3.53)pg/mL,(601.65±67.21)pg/mL,and(31.53±4.08)μmol/L,respectively,significantly higher than(11.66±2.12)points,(7.76±1.67)kU/L,(18.72±2.83)pg/mL,(542.74±61.71)pg/mL,and(31.53±4.08)μmol/L in the control group(P<0.05).Brain-derived neurotrophic factor(BDNF)in the study group was(4.18±0.89)μg/mL,which was significantly lower than(5.02±1.10)μg/mL in the control group(P<0.05).Pearson correlation analysis showed there was positive correlation between serum NRG1 and VILIP-1 expression(r=0.553,P<0.05).The results of multifactorial logistic regression analysis showed that NSE,NRG1,VILIP-1,and Hcy were risk factors for epilepsy secondary to cerebral infarction(P<0.05),and BDNF was a protective factor for epilepsy secondary to cerebral infarction(P<0.05).ROC results showed that the AUC of serum NRG1 and VILIP-1 for predicting epilepsy secondary to cerebral infarction was 0.844 and 0.768,respectively,significantly lower than 0.883 of NRG1 combined with VILIP-1(Z_(combination-NRG1)=2.058,Z_(combination-VILIP)-1=3.820,P<0.05).Conclusion Serum NRG1 and VILIP-1 were abnormally highly expressed in patients with epilepsy secondary to cerebral infarction,which are risk factors for patients with epilepsy secondary to cerebral infarction.Combined detection of the two is of high clinical value for the prediction of epilepsy secondary to cerebral infarction.
作者
吕秋杰
石福宏
单康娜
张建华
井晶
LYU Qiu-jie;SHI Fu-hong;SHAN Kang-na;ZHANG Jian-hua;JING Jing(Fifth Department of Neurology,Anyang Third People's Hospital,Anyang 455000,Henan,CHINA)
出处
《海南医学》
CAS
2024年第13期1849-1853,共5页
Hainan Medical Journal
基金
河南省安阳市科技局项目(编号:安科【2018】68号64)。
