血清EPO MMP-9水平预测老年结核性脑膜炎患者继发癫痫临床研究  

Clinical study of serum EPO and MMP-9 levels predicting secondary epilepsy in elderly patients with tuberculous meningitis

作　　者：王焕焕 曹金娟 李万里 张高才 于荣焕 WANG Huanhuan;CAO Jinjuan;LI Wanli;ZHANG Gaocai;YU Ronghuan(Kaifeng Central Hospital,Kaifeng 475000,China)

机构地区：[1]开封市中心医院,河南开封475000

出　　处：《中国实用神经疾病杂志》2020年第19期1685-1690,共6页Chinese Journal of Practical Nervous Diseases

基　　金：河南省高等学校重点科研项目计划(编号:16A320003)。

摘　　要：目的观察老年结核性脑膜炎患者血清红细胞生成素(EPO)、基质金属蛋白酶9(MMP-9)水平,分析血清EPO、MMP-9对患者继发癫痫的影响,探讨血清EPO、MMP-9对老年结核性脑膜炎患者继发癫痫的预测作用。方法回顾性分析201602―201911开封市中心医院收治的40例继发癫痫老年结核性脑膜炎患者的临床资料,将其纳入癫痫组,收集同期收治的未继发癫痫的40例老年结核性脑膜炎患者,将其纳入无癫痫组。统计老年结核性脑膜炎患者血清EPO、MMP-9水平并比较,分析血清EPO、MMP-9水平与老年结核性脑膜炎患者继发癫痫的相关性及对患者继发癫痫的预测作用。结果癫痫组血清EPO水平低于无癫痫组,血清MMP-9水平高于无癫痫组(P<0.05);经双变量Pearson直线相关检验显示,老年结核性脑膜炎患者血清EPO水平与MMP-9水平呈负相关(r<0,P<0.001);经Logistic回归分析显示,血清EPO低表达、MMP-9高表达是老年结核性脑膜炎患者继发癫痫的影响因素(OR>1,P<0.05);绘制ROC曲线,血清EPO、MMP-9水平单项检测用于继发癫痫预测的AUC分别为0.855、0.865,均有一定预测价值。结论老年结核性脑膜炎患者的血清EPO、MMP-9水平异常表达可能是继发癫痫的影响因素,其中EPO低表达、MMP-9过表达均会增加继发癫痫风险,建议老年结核性脑膜炎治疗期间检测血清EPO、MMP-9水平,可能对预测癫痫风险、指导早期干预有一定积极意义。Objective To observe the serum erythropoietin(EPO)and matrix metalloproteinase-9(MMP-9)levels in elderly patients with tuberculous meningitis,to analyze the effect of serum EPO and MMP-9 on patients with secondary epilepsy,and to explore the predictive effect of serum EPO and MMP-9 on patients with secondary epilepsy.Methods The clinical data of 40 elderly patients with tuberculous meningitis who were received in our hospital from February 2016 to November 2019 were retrospectively analyzed,and they were included in the epilepsy group.The clinical data of 40 elderly tuberculous meningitis patients without secondary epilepsy who were received by our hospital during the same period were collected,and they were included in the epilepsy free group.The serum EPO and MMP-9 levels of elderly tuberculous meningitis patients were counted and compared.The correlation between serum EPO and MMP-9 levels and secondary epilepsy in elderly tuberculous meningitis patients and predictive effects of serum EPO,MMP-9 on patients with secondary epilepsy was analyzed.Results The serum EPO level in the epilepsy group was lower than that in the non epilepsy group,and the serum MMP-9 level was higher than that in the non epilepsy group(P<0.05).The bivariate Pearson linear correlation test showed that the serum EPO level and MMP in elderly tuberculous meningitis patients-9 levels were negatively correlated(r<0,P<0.001);Logistic regression analysis showed that low expression of serum EPO and high expression of MMP-9 were the influencing factors of secondary epilepsy in elderly patients with tuberculous meningitis(OR>1,P<0.05);ROC curve is drawn,and the AUC from single detection of serum EPO and MMP-9 levels for the prediction of secondary epilepsy were:0.855 and 0.865 respectively,which have certain predictive value.Conclusion Abnormal expression of serum EPO and MMP-9 in elderly patients with tuberculous meningitis may be the influencing factors of patients with secondary epilepsy.Among them,low EPO expression and MMP-9 overexpression wil

关 键 词：结核性脑膜炎 癫痫 红细胞生成素 基质金属蛋白酶-9 

分 类 号：R742.1[医药卫生—神经病学与精神病学]