外周血1,25-(OH)_(2)D_(3)、神经元特异性烯醇化酶、神经胶质纤维酸性蛋白在小儿复杂性惊厥中的表达意义  

Expression of 1,25-(OH)_(2)D_(3),neuron specific enolase and glial fibrillary acidic protein in peripheral blood in children with complex febrile convulsion

作　　者：李梦洁 肖佳男 刘文娟 练芮含 张丽秀[1] LI Mengjie;XIAO Jianan;LIU Wenjuan;LIAN Ruihan;ZHANG Lixiu(Gansu Provincial Maternity and Child Healthcare Hospital,Lanzhou,Gansu 730050,China)

机构地区：[1]甘肃省妇幼保健院,甘肃兰州730050

出　　处：《中国儿童保健杂志》2023年第11期1254-1259,共6页Chinese Journal of Child Health Care

摘　　要：目的探讨外周血1,25-二羟维生素D_(3)[1,25-(OH)_(2)D_(3)]、神经元特异性烯醇化酶(NSE)、神经胶质纤维酸性蛋白(GFAP)在复杂性小儿热性惊厥(CFS)中的表达及意义。方法选取2021年3月—2022年3月在甘肃省妇幼保健院治疗的热性惊厥患儿(FS)92例,分为复杂组(40例)和单纯组(单纯性FS,52例),分析外周血1,25-(OH)_(2)D_(3)、NSE、GFAP的变化差异及与预后关系。结果复杂组患儿1,25-(OH)_(2)D_(3)水平低于单纯组[(14.40±3.32)vs.(19.27±4.11)],NSE[(22.10±5.65)vs.(15.02±5.13)]和GFAP[(50.20±9.30)vs.(36.63±9.02)]水平高于单纯组(t=6.113、6.279、7.058,P<0.05)。复杂组不同发作情况对应的患儿1,25-(OH)_(2)D_(3)、NSE和GFAF差异有统计学意义(发作持续时间t=6.103、2.736、3.996,24h内发作次数t=2.385、2.048、2.125,发作形式:t=2.862、2.704、2.304,P<0.05)。Spearman分析显示1,25-(OH)_(2)D_(3)水平与发作持续时间、24h内发作次数、发作形式呈负相关(r=-0.744、-0.321、-0.497,P<0.05),NSE、GFAP则与其呈正相关(NSE:r=0.375、0.302、0.373,GFAP:r=0.530、0.272、0.334,P<0.05)。预后不良患儿CFS比例为81.82%,明显高于预后良好患儿(χ^(2)=26.228,P<0.05);预后不良患儿外周血1,25-(OH)_(2)D_(3)水平低于预后良好患儿,NSE和GFAP水平高于预后良好患儿(t=2.893、3.762、3.323,P<0.05)。ROC显示,外周血1,25-(OH)_(2)D_(3)、NSE、GFAP预测预后不良的曲线下面积(AUC)分别为0.672、0.706和0.724(P<0.05)。结论外周血1,25-(OH)_(2)D_(3)水平下降及NSE、GFAP水平升高与CFS的发生及病情发作情况有关,且具有较高的预后预测价值。Objective To investigate the expression and significance of 1,25-dihydroxyvitamin D_(3)[1,25-(OH)_(2)D_(3)],neuron specific enolase(NSE)and glial fibrillary acidic protein(GFAP)in peripheral blood of children with complex febrile seizures(CFS).Methods A total of 92 children with febrile convulsions treated in Gansu Provincial Maternity and Child Healthcare Hospital from March 2021 to March 2022 were selected,including 40 children with CFS(complex group)and 52 children with simple febrile convulsions(simple group).The differences in 1,25-(OH)_(2)D_(3),NSE,GFAP in peripheral blood were analyzed and their correlations with prognosis and those with poor prognosis were analyzed.Results The level of 1,25-(OH),D,in complex group was lower than that in simple group(14.40±3.32 us.19.27±4.11,t=6.113),while thelevels of NSE(22.10±5.65vs.15.02±5.13,t=6.279)andGFAP(50.20±9.30 us.36.36±9.02,t=7.058)were significantly higher than those in simple group(P<0.05).The differences in 1,25-(OH)_(2)D_(3),NSE and GFAP levels were statistically significant in CFS children with different seizure condition(the duration of seizures attack t=6.103,2.736.3.996,number of attack within 24 hours:t=2.385,2.048,2.125.seizure forms:t=2.862.2.704.2.304,P<0.05).Spearman correlation showed that 1,25-(OH)_(2)D_(3)level was negatively correlated with the duration of attack,the number of attack within 24 hours and the form of attack(r=-0.744.-0.321,-0.497,P<0.05),while NSE and GFAP levels were positively correlated with the duration of seizures,the number of seizures within 24 hours and the form of seizures(NSE:r=0.375,0.302.0.373,GFAP:r=0.530.0.272,0.334,P<0.05).The rateof CFS in children with poor prognosis was 81.82%,which was significantly higher than that in children with good prognosis(χ^(2)=26.228,P<0.05).Serum 1,25-(OH)_(2)D_(3)level of children with poor prognosis was lower than that of children with good prognosis,while NSE and GFAP levels were significantly higher than that of children with good prognosis(t=2.893,3.762,3.323,P<0.05).The

关 键 词：1 25-二羟维生素D3 神经元特异性烯醇化酶 神经胶质纤维酸性蛋白 小儿复杂性热性惊厥 脑损伤 

分 类 号：R720.597[医药卫生—急诊医学]