轻度胃肠炎伴婴幼儿良性惊厥患儿的血清NSE、GFAP、UCH-L1水平及其对惊厥复发的预测价值  

Levels of serum NSE,GFAP,and UCH-L 1 in children with benign infantile convulsions associated with mild gastroenteritis and their predictive values on recurrent convulsions

作　　者：李春梅 刘俊芬[2] 刘振奎[1] 高娇娇 曹燕玲 卢艳辉[1] 马俊帅[3] 蔡春泉[4] LI Chun-mei;LIU Jun-fen;LIU Zhen-kui;GAO Jiao-jiao;CAO Yan-ling;LU Yan-hui;MA Jun-shuai;CAI Chun-quan(Department of Pediatric Internal Medicine,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China;Department of Nephrology,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China;Laboratory Medicine,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China;Pediatric Research Institute,Tianjin Children′s Hospital,Tianjin 300134,China)

机构地区：[1]河北北方学院附属第一医院儿内科,河北省张家口市075000 [2]河北北方学院附属第一医院肾内科,河北省张家口市075000 [3]河北北方学院附属第一医院检验科,河北省张家口市075000 [4]天津市儿童医院儿科研究所,天津市300134

出　　处：《广西医学》2022年第24期2847-2851,2856,共6页Guangxi Medical Journal

基　　金：河北省张家口市科技局重点研发计划项目(2021068D);河北省医学科学研究计划(20211012)。

摘　　要：目的探讨轻度胃肠炎伴婴幼儿良性惊厥(BICE)患儿的血清神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)、泛素羧基末端水解酶L1(UCH-L1)水平变化,以及三者对惊厥复发的预测价值。方法选取50例BICE患儿为研究组,50例轻度胃肠炎患儿作为对照组,比较两组患儿血清NSE、GFAP、UCH-L1水平。比较不同首次惊厥发作时间、惊厥单次发作持续时间、惊厥发作次数、随访1年内惊厥复发情况的BICE患儿的血清NSE、GFAP、UCH-L1水平。分析血清NSE、GFAP、UCH-L1水平与BICE患儿临床表现的关系。应用受试者工作特征(ROC)曲线分析血清NSE、GFAP、UCH-L1水平对BICE患儿惊厥复发的预测价值。结果研究组患儿血清NSE、GFAP、UCH-L1水平均高于对照组(均P<0.05)。首次惊厥发作时间越晚、惊厥单次发作持续时间越长、惊厥发作次数越多的BICE患儿,其血清NSE、GFAP、UCH-L1水平越高(均P<0.05)。BICE患儿血清NSE、GFAP、UCH-L1水平与首次惊厥发作时间、惊厥单次发作持续时间、惊厥发作次数、惊厥发作形式(全面性发作)及感染轮状病毒呈正相关(均P<0.05)。随访1年内复发的BICE患儿血清NSE、GFAP、UCH-L1水平高于无复发BICE患儿(均P<0.05)。ROC曲线显示,血清NSE、GFAP、UCH-L1水平预测BICE患儿惊厥复发的曲线下面积分别为0.805、0.743、0.836,三者联合预测BICE患儿惊厥复发的曲线下面积为0.914。结论BICE患儿血清NSE、GFAP、UCH-L1水平较单纯轻度胃肠炎患儿升高,且与脑损伤程度具有一定相关性。NSE、GFAP、UCH-L1三者预测BICE患儿惊厥复发具有较好的效能。Objective To investigate the changes of serum neuron-specific enolase(NSE),glial fibrillary acidic protein(GFAP)and ubiquitin carboxyl-terminal hydrolase L1(UCH-L1)in children with benign infantile convulsions associated with mild gastroenteritis(BICE),and their predictive values on recurrent convulsions.Methods A total of 50 children with BICE were selected as research group,and 50 children with mild gastroenteritis as control group,the levels of serum NSE,GFAP,and UCH-L1 were compared between the two groups.The serum NSE,GFAP,and UCH-L1 levels were compared between the BICE children with different episode time for first convulsion,duration of a single convulsive episode,times of convulsive episodes,and incidence of recurrent convulsions within 1-year follow-up.The relation of serum NSE,GFAP,and UCH-L1 levels with clinical manifestations of BICE children was analyzed.The predictive values of serum NSE,GFAP,and UCH-L1 levels on recurrent convulsions of BICE children were analyzed by the receiver operating characteristic(ROC)curve.Results The research group yielded higher levels of serum NSE,GFAP and UCH-L1 as compared with the control group(all P<0.05).The later the episode time for first convulsion,the longer the duration of a single convulsive episode,and the more times of convulsive episodes BICE children had,the higher levels of serum NSE,GFAP and UCH-L1 they suffered(all P<0.05).The levels of serum NSE,GFAP and UCH-L1 in BICE children positively correlated with episode time for first convulsion,duration of a single convulsive episode,times of convulsive episodes,episode formation of convulsions(general episode)and rotavirus infection(all P<0.05).Serum NSE,GFAP and UCH-L1 levels in BICE children relapsing within one year of follow-up were higher than those in non-recurrent BICE children(all P<0.05).The ROC curve revealed that the areas under the curve of serum NSE,GFAP,and UCH-L1 levels for predicting recurrent convulsions in BICE children were 0.805,0.743,and 0.836,respectively,and the area under the curve o

关 键 词：轻度胃肠炎伴婴幼儿良性惊厥 神经元特异性烯醇化酶 胶质纤维酸性蛋白 泛素羧基末端水解酶L1 复发 预测价值 

分 类 号：R720.597[医药卫生—急诊医学] R725.7[医药卫生—儿科]