血浆一氧化氮和大内皮素-1水平与脑卒中患者继发性癫痫的相关性分析  

The correlations between plasma nitric oxide,endothelin-1 levels and secondary epilepsy in stroke patients

作　　者：马玉青[1] 王圆圆 李娜[1] 樊青俐[1] MA Yu-qing;WANG Yuan-yuan;LI Na;FAN Qing-li(Department of Internal Medicine-Neurology,Qinghai Provincial People's Hospital,Qinghai,Xining 810000;Department of Internal Medicine-Neurology,Affiliated Hospital of Air Force Military Medical University,Shaanxi,Xian 710000,China)

机构地区：[1]青海省人民医院神经内科,青海西宁810000 [2]空军军医大学附属医院神经内科,陕西西安710000

出　　处：《热带医学杂志》2021年第7期865-868,共4页Journal of Tropical Medicine

基　　金：青海省科技计划项目(2019-ZJ-7101)。

摘　　要：目的分析血浆一氧化氮(NO)和大内皮素-1(Big ET-1)水平与脑卒中患者继发性癫痫发生的相关性。方法选取2018年1月-2019年7月青海省人民医院神经内科收治的290例脑卒中患者为研究对象,根据脑卒中后1个月内是否出现继发性癫痫,将其分为非继发性癫痫组(n=257)和继发性癫痫组(n=33)。使用酶联免疫吸附法(ELISA)测定血浆NO及Big ET-1水平。采用Pearson检验分析脑卒中后继发性癫痫患者血浆NO与Big ET-1水平的相关性;采用多变量Logistic回归分析影响脑卒中后继发性癫痫发生的危险因素;并绘制受试者工作特征(ROC)曲线,分析血浆NO及Big ET-1水平对脑卒中后继发性癫痫发生的预测价值。结果两组患者病灶部位相比,差异有统计学意义(P<0.05)。继发性癫痫组患者血浆NO及Big ET-1水平均显著高于非继发性癫痫组患者(P<0.05)。Pearson检验分析显示,脑卒中后继发性癫痫患者血浆NO与Big ET-1水平呈正相关(r=0.698,P<0.05)。Logistic回归结果显示,病灶部位、血浆NO及Big ET-1水平均是影响脑卒中后继发性癫痫发生的独立危险因素(P<0.05)。ROC曲线分析发现,血浆NO联合Big ET-1水平预测脑卒中后继发性癫痫发生的曲线下面积(AUC)高于两者单独诊断,其预测敏感度高达92.90%,特异度为81.80%。结论血浆NO及Big ET-1水平升高与脑卒中后继发性癫痫发生有关,可能作为评估脑卒中后继发性癫痫发生的有效指标。Objective To analyze the correlations between plasma nitric oxide(NO)and big endothelin-1(Big ET-1)levels and the occurrence of secondary epilepsy in stroke patients.Methods 290 stroke patients admitted to the Department of Neurology of our hospital from January 2018 to July 2019 were selected as subjects,and according to whether secondary epilepsy occurred within one month after stroke,the patients were divided into non-secondary epilepsy group(n=257)and secondary epilepsy group(n=33).Clinical data were collected;plasma NO and Big ET-1 levels were measured by enzyme-linked immunosorbent assay(ELISA).Pearson test was used to analyze the correlation between plasma NO and Big ET-1 level in patients with secondary epilepsy after stroke;multivariate logistic regression was used to analyze the risk factors of secondary epilepsy after stroke;the working characteristic curve(ROC curve)of subjects was drawn,and the predictive values of plasma NO and Big ET-1 levels for secondary epilepsy after stroke were analyzed.Results There was significant difference in the location of lesions between the two groups(P<0.05).The plasma NO and Big ET-1 levels in secondary epilepsy group were significantly higher than those in non-secondary epilepsy group(P<0.05).Pearson test analysis showed that plasma NO level was positively correlated with Big ET-1 level in patients with secondary epilepsy after stroke(P<0.05).Logistic regression showed that the location of the lesion,plasma NO and Big ET-1 levels were independent risk factors for secondary epilepsy after stroke(P<0.05).ROC curve analysis showed that the area under curve(AUC)of plasma NO combined with Big ET-1 level in predicting the occurrence of secondary epilepsy after stroke was higher than that of the two diagnostic methods alone,and the prediction sensitivity and specificity were 92.90% and 81.80%,respectively.Conclusion Elevated plasma NO and Big ET-1 levels were associated with secondary epilepsy after stroke,which might be an effective index for evaluating the occurrence of

关 键 词：脑卒中 继发性癫痫 一氧化氮 大内皮素-1 

分 类 号：R742.1[医药卫生—神经病学与精神病学]