摘要
目的探讨血清神经肽Y(NPY)、神经元特异性烯醇化酶(NSE)、C反应蛋白(CRP)在脑卒中后癫痫(PSE)发作患者中的表达意义。方法选择2022年6月至2024年6月聊城市第二人民医院神经内科完成2年随访的60例未发生PSE患者临床资料,将其纳入非PSE组。另选取同期60例发生PSE患者临床资料,将其纳入PSE组。统计并比较两组基线资料及入院时血清NPY、NSE、CRP水平。采用二元Logistic回归分析血清NPY、NSE、CRP与脑卒中患者PSE发生的关系,并行随机森林分析筛选重要因素。采用受试者工作特征曲线(ROC)检验基于血清NPY、NSE、CRP构建二元Logistic回归模型预测脑卒中患者PSE发生的价值。结果60例PSE患者,其中早发性癫痫37例(61.67%),迟发性癫痫23例(38.33%)。PSE组入院时NIHSS评分及血清NSE、CRP水平高于非PSE组,血清NPY水平低于非PSE组,病灶部位为皮质患者占比高于非PSE组(^(均)P<0.05);二元Logistic回归分析结果显示,入院时NIHSS评分高、病灶部位为皮质及血清NSE、CRP高表达是脑卒中患者PSE发生的危险因素(OR>1,P<0.05),血清NPY高表达是保护因素(OR<1,P<0.05);采用%IncMse打分并进行特征重要性排序,其中重要性前三分别为血清CRP、NPY、NSE,%IncMse×10^(-2)分别为26.985%、23.644%、19.410%,随机森林模型P=0.01,R^(2)=0.530;绘制ROC结果显示,血清NPY、NSE、CRP及联合检测预测脑卒中患者PSE发作的AUC为0.771、0.762、0.798、0.971,其中联合检测效能最高。结论血清NPY、NSE、CRP水平与PSE的发生密切相关,基于3者构建预测模型具有较好的预测效能,同时经随机森林分析显示NPY是最为重要的影响因素。
Objective To investigate the expression and significance of serum neuropeptide Y(NPY),neuron-specific enolase(NSE)and C-reactive protein(CRP)in patients with post-stroke epilepsy(PSE).Methods The clinical data of 60 patients without PSE who completed 2-year follow-up in the Department of Neurology,Liaocheng Second People's Hospital from June 2022 to June 2024 were selected and included in the non-PSE group.In addition,the clinical data of 60 patients with PSE in the same period were selected and included in the PSE group.Baseline data and serum NPY,NSE and CRP levels at admission were compared between the two groups.Binary Logistic regression was used to analyze the relationship between serum NPY,NSE,CRP and PSE in stroke patients,and random forest analysis was used to screen important factors.The receiver operating characteristic curve(ROC)was used to test the value of binary Logistic regression model based on serum NPY,NSE and CRP in predicting the occurrence of PSE in stroke patients.Results Of the 60 patients with PSE,37(61.67%)had early-onset epilepsy and 23(38.33%)had delayed epilepsy.The NIHSS score at admission and serum NSE and CRP levels in the PSE group were higher than those in the non-PSE group,the serum NPY level was lower than that in the non-PSE group,and the proportion of patients with cortical lesions was higher than that in the non-PSE group(^(All) P<0.05).The results of binary Logistic regression analysis showed that high NIHSS score at admission,high expression of NSE and CRP in cortex and serum were risk factors for PSE in stroke patients(OR>1,P<0.05),and high expression of NPY in serum was a protective factor for PSE in stroke patients(OR<1,P<0.05).The%IncMse score was used to rank the importance of features.The top three importance were serum CRP,NPY and NSE,and%IncMse×10^(-2 )were 26.985%,23.644%and 19.410%,respectively.The random forest model P=0.01,R^(2)=0.530;the ROC results showed that the AUC of serum NPY,NSE,CRP and combined detection in predicting PSE attack in stroke patients was 0.771,0.762,0.798 and 0.971,respectively,and the combined detection had the highest efficiency.Conclusion Serum NPY,NSE and CRP levels are closely related to the occurrence of PSE.The prediction model based on the three has good predictive efficacy.At the same time,random forest analysis shows that NPY is the most important influencing factor.
作者
陶伟
钟芳芳
王爱滨
刘俊娥
许秀丽
张子斌
Tao Wei;Zhong Fangfang;Wang Aibin;Liu June;Xu Xiuli;Zhang Zibin(Department of Neurology,the Liaocheng Second People's Hospital,Shandong 252600,China)
出处
《脑与神经疾病杂志》
2025年第8期479-484,共6页
Journal of Brain and Nervous Diseases
基金
山东省中医药科技项目(Q-2022040)。
