改良aEEG评分联合S-100β和GFAP对儿童癫痫性脑病早期诊断价值的分析  

Analysis of the value of modified aEEG score combined with S-100β and GFAP in the early diagnosis of epileptic encephalopathy in children

作　　者：王君[1] 罗琼[1] 张美[1] Wang Jun;Luo Qiong;Zhang Mei(Center of Pediatrics,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830000,China)

机构地区：[1]新疆医科大学第一附属医院儿科中心,新疆乌鲁木齐830000

出　　处：《中国妇幼健康研究》2023年第5期25-29,共5页Chinese Journal of Woman and Child Health Research

基　　金：新疆医科大学第一附属医院青年基金资助项目(20142RQN17)。

摘　　要：目的 探讨改良振幅整合脑电图(aEEG)评分联合中枢神经特异蛋白S100β(S-100β)和神经胶质纤维酸性蛋白(GFAP)对儿童癫痫性脑病早期诊断的价值。方法 选择2018年1月至2020年12月在新疆医科大学第一附属医院小儿神经内科就诊的癫痫持续状态患儿92例为研究对象。收集患儿的临床资料,在入院1~3d内行aEEG检查,入院24h内抽取空腹外周静脉血2mL检测S-100β和GFAP水平。根据有无癫痫性脑病将患儿分为癫痫性脑病组(34例)与非癫痫性脑病组(58例),比较两组的改良aEEG评分及S-100β、GFAP水平,并采用受试者工作特征(ROC)曲线评估各指标单独检测与联合检测对癫痫持续状态患儿癫痫性脑病的早期诊断价值。结果 在92例癫痫持续状态患儿中,有34例诊断为癫痫性脑病。癫痫性脑病组患儿的改良aEEG评分显著高于非癫痫性脑病组,S-100β和GFAP水平也显著高于非癫痫性脑病组,差异均有统计学意义(t值分别为3.411、7.261、6.579,P<0.05)。ROC曲线分析显示,改良aEEG评分及S-100β、GFAP水平对癫痫持续状态患儿癫痫性脑病早期诊断的截断值分别为8.10分、1.16μg/L、4.61ng/L,曲线下面积(AUC)分别为0.751、0.876、0.809,三者联合诊断的AUC为0.908,联合诊断效能均高于单独指标的检测(Z值分别为4.821、5.013、3.961,P<0.05)。结论 儿童癫痫性脑病可引起改良aEEG评分及S-100β、GFAP水平的改变,其均可作为儿童癫痫性脑病早期诊断指标,三者联合检测可提高诊断效能。Objective To explore the value of modified aEEG score combined with S-100β and GFAP in the early diagnosis of epileptic encephalopathy in children.Methods 92 children with status epilepticus who were treated in the department of pediatric neurology of our hospital from January 2018 to December 2020 were selected for the study.The clinical data of the children were collected, and aEEG examination was performed within 1 to 3 days after admission, and 2ml of fasting peripheral venous blood was drawn within 24 hours of admission to detect S-100β and GFAP.According to the presence or absence of epileptic encephalopathy, the children were divided into two groups, and the two groups were compared with the modified aEEG score combined with S-100β and GFAP.The ROC analysis method was used to evaluate the value of individual detection and combined detection of each index in the early diagnosis of epileptic encephalopathy in children with status epilepticus.Results A total of 34 of the 92 children with status epilepticus in this study were confirmed to have epileptic encephalopathy. There was no significant difference in gender, imaging examination results and comorbidities between the two groups of children(P>0.05). The modified aEEG scores of children with epileptic encephalopathy were lower than those of the non-epileptic encephalopathy group, and S-100β and GFAP were higher than those of the non-epileptic encephalopathy group. The difference was statistically significant(P<0.05).ROC analysis results showed that the cut-off values of modified aEEG score, S-100β and GFAP for early diagnosis of epileptic encephalopathy in children with status epilepticus were 8.1 points, 1.2μg/L, 4.6ng/L, and AUC were 0.751, 0.876 and 0.809,respectively, the AUC of the three combined diagnosis (referring to the improved aEEG score higher than the cut-off value or S-100β and GFAP lower than the cut-off value in the combined detection) is 0.908, and its diagnostic efficiency is higher than that of each indicator alone Detection(P<0.05

关 键 词：改良aEEG评分 中枢神经特异蛋白S100β 神经胶质纤维酸性蛋白 儿童 癫痫性脑病 

分 类 号：R179[医药卫生—妇幼卫生保健]