血清BDNF、NfL检测在热性惊厥诊断中的价值  

Diagnosis value of serum BDNF and NfL in febrile seizures

作　　者：苏晓芳 陈全景 周凤霞 李艳娟 SU Xiaofang;CHEN Quanjing;ZHOU Fengxia;LI Yanjuan(Department of Pediatrics,Dongfeng Hospital Affiliated to Hubei Medical College,Shiyan,Hubei 442000,China)

机构地区：[1]湖北医药学院附属东风医院儿科,湖北十堰442000

出　　处：《国际检验医学杂志》2023年第19期2360-2364,共5页International Journal of Laboratory Medicine

基　　金：湖北省十堰市科学技术研究与开发项目计划(18Y84)。

摘　　要：目的探讨血清脑源性神经营养因子(BDNF)、神经丝轻链(Nfl)对热性惊厥患儿的诊断价值。方法选取2021年3月3日至2022年3月3日该院儿科收治的35例单纯性热性惊厥(SFS)患儿作为SFS组,以及80例因呼吸道感染引起发热但未惊厥的患儿作为对照组。比较两组患儿血清C反应蛋白(CRP)、BDNF、Nfl、和肽素水平,绘制受试者工作特征(ROC)曲线分析血清BDNF、Nfl水平在SFS中的诊断价值,选择最佳的诊断临界值,并验证各指标的诊断特异度。结果SFS组患儿CRP、BDNF、Nfl、和肽素水平均高于对照组(P<0.001)。相关性分析显示,BDNF、Nfl水平均与CRP水平呈正相关(r=0.453、0.596,均P<0.001)。ROC曲线分析显示,以BDNF或Nfl诊断SFS的曲线下面积(AUC)分别为0.9118(95%CI:0.8437~0.9779)和0.8962(95%CI:0.8166~0.9758)。BDNF≥8.0 ng/mL、Nfl≥22.0 pg/mL对SFS有良好的诊断特异度,二者联合和肽素≥6.0 pmol/L可提高和肽素单独诊断的特异度。结论血清BDNF、Nfl水平升高可能与热性惊厥发生具有相关性,且BDNF、Nfl对热性惊厥具有较好的诊断特异度,可提高和肽素的单独诊断价值。Objective To explore the diagnostic value of serum brain-derived neurotrophic factor(BDNF)and neurofilament light chain(Nfl)in children with febrile seizures.Methods From March 3,2021 to March 3,2022,35 children with simple febrile seizures(SFS)admitted to the Department of Pediatrics of this hospital were selected as the SFS group,and 80 children with fever due to respiratory infection but without seizure were selected as the control group.Serum C-reactive protein(CRP),BDNF,Nfl,and copeptin levels were compared between the two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum BDNF and Nfl levels in SFS.Mean while,the best diagnostic cut-off value were selected,and the diagnostic specificity of each indicator was verified.Results The levels of CRP,BDNF,Nfl,copeptin in SFS group were higher than those in control group(P<0.001).Correlation analysis showed that BDNF and Nfl levels positively correlated with CRP levels(r=0.453,0.596,both P<0.001).ROC curve analysis showed that the area under the curve(AUC)of BDNF and Nfl in the diagnosis of SFS were 0.9118(95%CI:0.8437-0.9779)and 0.8962(95%CI:0.8166-0.9758),respectively.In addition,BDNF≥8.0 ng/mL and Nfl≥22.0 pg/mL had good diagnostic specificity for SFS,and the combination of both and copeptin≥6.0 pmol/L could improve the diagnostic specificity of copeptin alone.Conclusion The elevated levels serum BDNF and Nfl may be associated with the occurrence of febrile seizures,and BDNF combined with Nfl has better diagnostic specificity for febrile seizures,which can improve the diagnostic value of copeptin alone.

关 键 词：热性惊厥 脑源性神经营养因子 神经丝轻链 和肽素 

分 类 号：R720.597[医药卫生—急诊医学]