GFAP联合cfDNA测定在复杂性热性惊厥脑损伤中的临床研究  

Clinical study of GFAP combined with cfDNA determination in brain damage caused by complex febrile seizures

作　　者：凌寅杰 朱焰[1] 施明杰 路攀 袁琛[1] LING Yinjie;ZHU Yan;SHI Mingjie;LU Pan;YUAN Chen(Department of Pediatrics,Huzhou First People’s Hospital in Zhejiang Province,Huzhou313000,China)

机构地区：[1]浙江省湖州市第一人民医院儿科,浙江湖州313000

出　　处：《中国现代医生》2020年第17期29-32,共4页China Modern Doctor

基　　金：浙江省自然科学基金项目(LGF18H090012);浙江省湖州市科技局项目(2017GYB12)。

摘　　要：目的研究复杂性热性惊厥患儿静脉血GFAP浓度、静脉血和脑脊液的cfDNA含量,并评价两者的相关性。方法选择2019年1~12月在湖州市第一人民医院住院治疗的78例CFS患儿作为研究组,选择同期因发热疑似伴颅内感染,最终经脑脊液检查、脑电图、头颅MRI和病情观察排除颅内感染的住院患儿27例为对照组。分别测定两组患儿入院第1天和第5天的静脉血GFAP浓度,测定两组患儿入院当天的静脉血和脑脊液cfDNA含量。结果研究组患儿静脉血GFAP水平(第1天和第5天)均较对照组水平升高,差异有统计学意义(P<0.05)。研究组患儿与对照组患儿之间的脑脊液cfDNA完整度具有显著性差异,且研究组患儿的脑脊液cfDNA含量较对照组显著增加,差异有统计学意义(P<0.05)。患儿静脉血GFAP水平与脑脊液cfDNA水平呈正相关关系。结论通过GFAP联合cfDNA含量测定,证实CFS患儿在分子和细胞层面存在惊厥后脑损伤。惊厥导致脑损伤的持续性,而非短暂消失,并可导致神经细胞死亡,引起脑脊液cfDNA浓度明显增加。Objective To study the GFAP concentration of venous blood,cfDNA content in venous blood and cerebrospinal fluid in children patients with complex febrile seizures,and to evaluate the correlation between the two.Methods From January 2019 to December 2019,78 children patients with CFS who were hospitalized for treatment in Huzhou First People's Hospital were selected as the study group.27 hospitalized children patients suspected to be complicated with intracranial infection due to fever during the same period,who were excluded from intracranial infection through cerebrospinal fluid examination,electroencephalogram,skull MRI,and disease observation,were selected as the control group.The venous blood GFAP concentration in the two groups of children patients was determined on Day 1 and Day 5 of admission.The venous blood and cerebrospinal fluid(cfDNA)contents of the two groups of children patients were determined on the day of admission.Results The venous blood GFAP levels in the study group(Day 1 and Day 5)were higher than those in the control group,and the difference was statistically significant(P<0.05).There were significant differences in cerebrospinal fluid cfDNA integrity in children patients between the study group and the control group.The content of cfDNA in cerebrospinal fluid in the study group was increased significantly compared with that in the control group,and the difference was statistically significant(P<0.05).There was a positive correlation between venous blood GFAP levels and cerebrospinal fluid cfDNA levels in children patients.Conclusion GFAP combined with cfDNA determination confirms that children patients with CFS have brain damage after seizures at the molecular and cellular levels.Seizures cause persistent,not temporary disappearance of brain damage,and can lead to the death of nerve cells,causing a significant increase in cerebrospinal fluid cfDNA concentration.

关 键 词：GFAP cfDNA 复杂性热性惊厥 脑脊液 相关关系 

分 类 号：R720.597[医药卫生—急诊医学]