AQP4、MMP-9及HMGB1预测癫痫患儿认知功能损害的价值分析  

Value analysis of AQP4,MMP-9 and HMGB1 in predicting cognitive impairment in children with epilepsy

作　　者：冯娇娇 邢雅杰 刘丹丹 王立华[1] FENG Jiaojiao;XING Yajie;LIU Dandan;WANG Lihua(Department of Pediatrics,Handan Central Hospital of Hebei Province,Hebei Handan 056001,China;Department of Pediatrics,Handan First Hospital of Hebei Province,Hebei Handan 056002,China)

机构地区：[1]河北省邯郸市中心医院儿科,河北邯郸056001 [2]河北省邯郸市第一医院儿科,河北邯郸056002

出　　处：《中国妇幼健康研究》2023年第6期28-33,共6页Chinese Journal of Woman and Child Health Research

基　　金：河北省医学科学研究课题计划(201901849)。

摘　　要：目的探讨血清水通道蛋白4(AQP4)、基质金属蛋白酶-9(MMP-9)和高迁移率族蛋白B1(HMGB1)与癫痫患儿认知功能损害的关系及其预测价值。方法选取2018年1月至2021年10月河北省邯郸市中心医院收治的150例癫痫患儿为研究对象。根据蒙特利尔认知评估量表(MoCA)评分将150例癫痫患儿分为认知障碍组(n=69)和认知正常组(n=81),并选取同期80例体检正常儿童纳入健康对照组,观察各组血清AQP4、MMP-9及HMGB1水平;进行Pearson相关分析各指标与认知功能损害的关系,并采用Logistic回归分析癫痫患儿认知功能损害危险因素;通过绘制受试者工作特征曲线(ROC)、计算曲线下面积(AUC)分析AQP4、MMP-9及HMGB1单独或联合对癫痫患儿认知功能损害的预测价值。结果三组癫痫患儿血清AQP4、MMP-9、HMGB1水平及MoCA评分差异均有统计学意义,进一步两两比较发现,认知损害组、认知正常组、健康对照组的AQP4水平依次升高,MMP-9及HMGB1水平依次降低(F值分别为1384.902、43.666、63.059,P<0.05);认知损害组MoCA评分低于认知正常组和健康对照组(F=1365.424,P<0.05),但认知正常组和健康对照组MoCA评分无显著差异;Pearson相关性分析显示,血清AQP4水平与癫痫患儿MoCA评分呈正相关(r=0.824,P<0.05),血清MMP-9及HMGB1水平与MoCA评分呈负相关(r值分别为-0.426、-0.463,P<0.05);Logistic回归分析结果显示,血清AQP4水平增加是癫痫患儿认知功能损害的保护因素(OR=0.557,P<0.05),MMP-9、HMGB1水平较高及病程较长是癫痫患儿认知功能损害的危险因素(OR值分别为1.658、2.124、1.215,P<0.05);ROC曲线分析显示三指标单独及联合应用时AUC(95%CI)分别为0.797(0.652~0.941)、0.720(0.519~0.920)、0.722(0.477~0.966)、0.862(0.742~0.972),其中联合应用诊断效能最高。结论AQP4、MMP-9及HMGB1在伴有认知功能损害的癫痫患儿血清中存在异常表达,是癫痫患儿认知功能损害的独立影响因素,三者联合检测对癫Objective To investigate the relationships between serum aquaporin-4(AQP4),matrix metalloproteinase-9(MMP-9)and high mobility group box 1(HMGB1)and cognitive impairment in children with epilepsy and their predictive values.Methods A total of 150 children with epilepsy and treated in Handan Central Hospital of Hebei Province from January 2018 to October 2021 were selected as the research objects.According to the score of Montreal Cognitive Assessment(MoCA),150 children with epilepsy were divided into the cognitive impairment group(n=69)and the cognitive normal group(n=81).And 80 children with normal physical examination during the same period were included in the healthy control group.The levels of serum AQP4,MMP-9 and HMGB1 were observed in each group.Pearson correlation analysis was used to analyze the relationship between each index and cognitive impairment,and Logistic regression was used to analyze the risk factors of cognitive impairment in children with epilepsy.The predictive values of AQP4,MMP-9 and HMGBl alone or in combination on cognitive impairment in children with epilepsy were analyzed by drawing the receiver operating characteristic(ROC)curve and calculating the AUC(area under the curve).Results There were significant differences in the levels of serum AQP4,MMP-9 and HMGB1 and MoCA score among the three groups.Further pairwise comparison found that the levels of AQP4 in the cognitive impairment group,the cognitive normal group and the healthy control group were increased successively,while the levels of MMP-9 and HMGB1 were decreased successively(F=1384.902,43.666 and 63.059,respectively,P<0.05).The MoCA score of the cognitive impairment group was significantly lower than that of the cognitive normal group and the healthy control group(F=1365.424,P<0.05),while there was no significant difference of MoCA score between the cognitive normal group and the healthy control group(P>0.05).Pearson correlation analysis showed that the level of serum AQP4 was positively correlated with MoCA score in children

关 键 词：癫痫 儿童 血清水通道蛋白4 基质金属蛋白酶-9 高迁移率族蛋白B1 认知功能损害 预测价值 

分 类 号：R179[医药卫生—妇幼卫生保健]