血清新饱食分子蛋白1联合癫痫持续状态严重程度评分量表评分对儿童癫痫持续状态近期预后的预测价值分析  

Analysis of the predictive value of serum Nesfatin-1 combined with the Status Epilepticus Severity Score in the short-term prognosis of children with status epilepticus

作　　者：张群群 刘灵芝[1] 苏军[1] 陈晨[1] 吕艳琦[1] 金志鹏[1] 徐凯丽 Zhang Qunqun;Liu Lingzhi;Su Jun;Chen Chen;Lyu Yanqi;Jin Zhipeng;Xu Kaili(Department of Medical Intensive Care Unit,Children′s Hospital Affiliated to Zhengzhou University,Henan Children′s Hospital,Zhengzhou Children′s Hospital,Zhengzhou 450000,China;Internal Medicine-Neurology,Children′s Hospital Affiliated to Zhengzhou University,Henan Children′s Hospital,Zhengzhou Children′s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院,河南省儿童医院,郑州儿童医院内科监护室,郑州450000 [2]郑州大学附属儿童医院,河南省儿童医院,郑州儿童医院神经内科,郑州450000

出　　处：《中华实用儿科临床杂志》2022年第9期687-691,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：河南省医学科技攻关项目(LHGJ20190957)。

摘　　要：目的分析血清新饱食分子蛋白1(Nesfatin-1)联合癫痫持续状态严重程度评分量表(STESS)评分对儿童癫痫持续状态(SE)近期预后的预测价值。方法回顾性分析郑州大学附属儿童医院, 河南省儿童医院, 郑州儿童医院2016年1月至2020年1月收治的145例SE患儿的临床资料, 患儿入院后均检测血清Nesfatin-1水平, 并进行STESS评分。根据患儿出院时格拉斯哥预后评分量表(GOS)评价结果分为预后不良组(<5分)与预后良好组(5分), 单因素及多因素Logisitc回归分析血清Nesfatin-1水平与STESS评分是否为影响儿童SE近期预后的危险因素。受试者工作特征(ROC)曲线评价血清Nesfatin-1水平联合STESS评分对儿童SE近期预后的预测价值。结果 145例患儿出院时25例(17.24%)GOS评分<5分为预后不良组, 120例为预后良好组。预后不良组全面性发作(88.00%比66.67%)、SE发作时间>1 h(76.00%比27.50%)、入住儿童重症监护病房(PICU)(76.00%比37.50%)、实施气管插管(16.00%比5.00%)、脑电图结果异常(73.91%比41.03%)、头颅影像学结果异常(82.61%比29.49%)占比及血清Nesfatin-1水平[(3.65±1.45) μg/L比(2.20±0.77) μg/L]、STESS评分[(3.01±0.75)分比(1.80±0.60)分]均高于预后良好组, 差异均有统计学意义(均P<0.05);Logisitic回归分析显示SE发作时间>1 h、入住PICU、脑电图检查异常、头颅影像学检查异常、血清Nesfatin-1水平与STESS评分是影响SE患儿近期预后不良的独立危险因素(OR=4.217、3.456、2.626、4.109、3.040、2.012, 均P<0.001);血清Nesfatin-1与STESS评分分别以3.01 μg/L、2.38分为最佳截断值, 联合预测SE患儿近期预后不良的约登指数为0.736, ROC曲线下面积(AUC)为0.921(95%CI:0.861~0.959), 均优于Nesfatin-1与STESS评分单独预测[0.447, 0.795(95%CI:0.720~0.858);0.562, 0.859(95%CI:0.792~0.911)]。结论血清Nesfatin-1水平与STESS评分异常升高是儿童SE预后不良的危险因素, 二者联合对近期预后不良有较高的预�Objective To analyze the predictive value of serum Nesfatin-1 combined with the Status Epilepticus Severity Scale(STESS)score on the short-term prognosis of children with status epilepticus(SE).Methods A clinical data of 145 children with SE who were admitted to the Children′s Hospital Affiliated to Zhengzhou University,Henan Children′s Hospital,Zhengzhou Children′s Hospital,from January 2016 to January 2020 were analyzed retrospectively.After admission,the serum levels of Nesfatin-1 and the STESS score were measured.According to the Glasgow Outcome Scale(GOS)score at discharge,children with SE were divided into poor prognosis group(<5 scores)and good prognosis group(5 scores).Univariate and multivariate Logisitc regression analyses were performed to analyze influence of the serum Nesfatin-1 level and STESS score on the short-term prognosis of children with SE.Receiver operating characteristic(ROC)curve was depicted to evaluate the predictive value of serum Nesfatin-1 level combined with STESS score in the short-term prognosis of children with SE.Results Twenty-five cases out of 145(17.24%)children with SE were discharged with a GOS score of<5(poor prognosis group),120 cases were in the good prognosis group.In the poor prognosis group,the overall attack(88.00%vs.66.67%),attack time of SE>1 h(76.00%vs.27.50%),admission to child intensive care unit(PICU)(76.00%vs.37.50%),implementation of endotracheal intubation(16.00%vs.5.00%),abnormal electroencephalogram(EEG)results(73.91%vs.41.03%),abnormal proportion of head imaging results(82.61%vs.29.49%),serum Nesfatin-1 level[(3.65±1.45)μg/L vs.(2.20±0.77)μg/L]and STESS score[(3.01±0.75)points vs.(1.80±0.60)points]were significantly higher than those in the good prognosis group(all P<0.05).Logistic regression analysis showed that the attack time of SE>1 h,admission to PICU,abnormal EEG,abnormal proportion of head imaging results,serum Nesfatin-1 level and STESS score were independent risk factors for the poor short-term prognosis of children with SE(OR=4.217,3.

关 键 词：癫痫持续状态 新饱食分子蛋白1 癫痫持续状态严重程度评分量表 预后预测 

分 类 号：R742.1[医药卫生—神经病学与精神病学]