C反应蛋白联合转化生长因子β活化激酶1对脑卒中后癫痫发作的预测价值研究  

Predictive value of C-reactive protein combined with transforming growth factor β-activated kinase 1 for epileptic seizures after stroke

作　　者：李乐超 孙洁[2] 黄颖[1] LI Le-chao;SUN Jie;HUANG Ying(Department of Neurology,Xuzhou Central Hospital,Xuzhou 221000,China;Department of Rehabilitation Medicine,Xuzhou Central Hospital,Xuzhou 221000,China)

机构地区：[1]徐州市中心医院神经内科,江苏徐州221000 [2]徐州市中心医院康复医学科,江苏徐州221000

出　　处：《哈尔滨医科大学学报》2022年第1期16-20,共5页Journal of Harbin Medical University

基　　金：江苏省自然科学基金资助项目(BK20171172)。

摘　　要：目的 探究C反应蛋白(C-reactive protein, CRP)联合转化生长因子β活化激酶1(tansforming growth factorβ-activated kinase 1,TAK1)对脑卒中后癫痫发作的预测价值。方法 选取2019年7月~2021年6月本院收治的216例脑卒中患者为研究对象。统计住院期间脑卒中患者癫痫发作情况,并依据癫痫是否发作分为发作组(18例)和未发作组(198例)。对比发作组和未发作组患者的临床资料。Logistic多因素回归分析影响脑卒中患者癫痫发作的有关因素。绘制受试者工作特征曲线(receiver operating characteristic curve, ROC),以曲线下面积(area under curve, AUC)评价CRP联合TAK1对脑卒中患者癫痫发作的预测价值。结果 本研究中216例脑卒中患者住院期间癫痫发作率为8.33%。发作组入院时美国国立卫生院卒中量表(National Institutes of Health Stroke Scale, NIHSS)评分、脑卒中病灶位于皮质占比、脑卒中病灶累及多脑叶占比、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、血清CRP及外周血TAK1 mRNA表达水平均高于未发作组(P<0.05)。Logistic多因素分析结果显示,入院时NIHSS评分、脑卒中病灶位于皮质、血清CRP及外周血TAK1 mRNA表达水平均为影响脑卒中患者癫痫发作的危险因素(OR=2.863、3.728、3.152、3.677,P<0.05)。ROC分析显示,血清CRP、TAK1 mRNA预测脑卒中患者癫痫发作的最佳截断点分别为7.43 mg/mL、1.89,且血清CRP、TAK1两者联合预测脑卒中患者癫痫发作的AUC为0.904,高于CRP、TAK1 mRNA单独预测的AUC(P<0.05)。结论 CRP、TAK1 mRNA两者联合对脑卒中后癫痫发作的预测效能较高,可作为对脑卒中后癫痫发作进行预测的重要参考指标。Objective To explore the predictive value of C-reactive protein(CRP) combined with transforming growth factor β-activated kinase 1(TAK1) for epileptic seizures after stroke. Methods A total of 216 stroke patients admitted to our hospital from July 2019 to June 2021 were selected as the research objects. The seizures of stroke patients during hospitalization were counted, and the patients were divided into seizure group(18 cases) and non-seizure group(198 cases) according to whether the seizures occurred. The clinical data of patients in the seizure group and the non-seizure group were compared. Logistic multivariate regression analysis was used to analyze related factors affecting epileptic seizures in stroke patients. A receiver operating characteristic curve(ROC) was drawn and the area under the curve(AUC) was used to evaluate the predictive value of CRP combined with TAK1 for epileptic seizures in stroke patients. Results The seizure rate of 216 stroke patients during hospitalization was 8.33%. In the seizure group, the National Institutes of Health Stroke Scale(NIHSS) score, the proportion of stroke lesions located in the cortex, the proportion of stroke lesions involving multiple brain lobes, tumor necrosis factor-α(TNF-α), serum CRP and peripheral blood TAK1 mRNA expression levels were higher than those of the non-seizure group(P<0.05). Logistic multivariate analysis showed that the NIHSS score, stroke lesions located in the cortex, serum CRP and peripheral blood TAK1 mRNA expression levels at admission were all risk factors affecting seizures in stroke patients(OR=2.863, 3.728, 3.152, 3.677, P<0.05). ROC analysis showed that the best cut-off points of serum CRP and TAK1 mRNA for predicting seizures in stroke patients were 7.43 mg/mL and 1.89, respectively, and the combination of serum CRP and TAK1 in predicting seizures in stroke patients had an AUC of 0.904, which was higher than the AUC predicted by CRP and TAK1 mRNA alone(P<0.05). Conclusion The combination of CRP and TAK1 mRNA has a high predictive

关 键 词：C反应蛋白 转化生长因子β活化激酶1 脑卒中 癫痫 预测 

分 类 号：R742.1[医药卫生—神经病学与精神病学]