血清AQP4、NFL、BAFF水平与癫痫患儿认知功能的相关性及其对认知功能损害的评估价值  

Correlation between serum aquaporin 4,neurofilament light chain protein,and B-cell activating factor levels and cognitive function in children with epilepsy and their evaluation value for cognitive function impairment

作　　者：尚凤伟[1] 王瑞丽[1] 李海珍 马振林[1] SHANG Feng-wei;WANG Rui-li;LI Hai-zhen;MA Zhen-lin(Department of Pediatrics,Zhoukou Central Hospital,Zhoukou 466100,Henan,CHINA)

机构地区：[1]周口市中心医院儿科,河南周口466100

出　　处：《海南医学》2024年第10期1426-1430,共5页Hainan Medical Journal

基　　金：2021年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20212651)。

摘　　要：目的探讨癫痫患儿血清水通道蛋白4(AQP4)、神经丝轻链蛋白(NFL)、B细胞活化因子(BAFF)水平与认知功能的相关性及其对认知功能损害的评估价值。方法选取2020年5月至2023年5月周口市中心医院收治的126例癫痫患儿作为研究对象,依据蒙特利尔认知评估量表(MoCA)分为认知损害组58例和认知正常组68例,同时选取同期体检正常儿童42例作为对照组。比较三组受检者的血清AQP4、NFL、BAFF水平;采用Pearson法分析血清AQP4、NFL、BAFF水平与国立医院癫痫发作严重程度量表(NHS3)、MoCA评分的相关性;采用多因素Logistic回归分析认知功能损害的影响因素,绘制受试者工作特征曲线(ROC)及曲线下面积(AUC)分析血清AQP4、NFL、BAFF水平对认知功能损害的评估价值。结果认知损害组患者的血清AQP4水平明显低于认知正常组和对照组,且认知正常组明显低于对照组,认知损害组患者的血清NFL、BAFF水平则明显高于认知正常组和对照组,且认知正常组明显高于对照组,差异均有统计学意义(P<0.05);认知损害组患者的NHS3评分为(14.25±3.75)分,明显高于认知正常组的(10.08±3.16)分,差异有统计学意义(P<0.05);经Pearson法分析结果显示,AQP4与MoCA评分呈正相关(r=0.528,P<0.05),与NHS3评分呈负相关(r=-0.429,P<0.05),而NFL、BAFF与MoCA评分呈负相关(r=-0.438、-0.501,P<0.05),NFL、BAFF与NHS3评分呈正相关(r=0.442、0.538,P<0.05);经多因素Logistic回归分析结果显示,全面性发作、发作频率升高、AQP4水平降低及NFL、BAFF水平升高均为认知功能损害的危险因素(P<0.05);经ROC分析结果显示,血清AQP4、NFL、BAFF、AQP4+NFL、AQP4+BAFF、BAFF+NFL、AQP4+NFL+BAFF评估认知功能损害的AUC分别为0.716、0.705、0.786、0.834、0.818、0.828、0.940,且AQP4+NFL+BAFF评估认知功能损害的AUC明显大于任意两项指标联合评估、单独指标评估(P<0.05)。结论癫痫患儿认知功能损害者血清AQP4水平降低,血Objective To investigate the correlation between the levels of aquaporin 4(AQP4),neurofilament light chain protein(NFL),and B-cell activating factor(BAFF)in children with epilepsy and their evaluation value for cognitive function impairment.Methods A total of 126 children with epilepsy admitted to the Zhoukou Central Hospi-tal from May 2020 to May 2023 were selected as the research objects.They were divided into a cognitive impairment group(n=58)and a cognitive normal group(n=68)according to the Montreal Cognitive Assessment(MoCA).At the same time,42 children with normal physical examination were selected as a control group.The serum AQP4,NFL,and BAFF levels were compared among the three groups.Pearson analysis was used to investigate the correlation between serum AQP4,NFL,BAFF levels and the National Hospital Severity of Seizures Scale(NHS3)and MoCA scores.Multi-variate logistic regression analysis was used to investigate the influencing factors of cognitive function impairment.The receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the evaluation value of serum AQP4,NFL,BAFF levels on cognitive function impairment.Results The serum AQP4 level in the cognitive impairment group was significantly lower than that in the cognitive normal group and the control group,and the level in the cognitive normal group was significantly lower than that in the control group;the serum NFL and BAFF levels in the cognitive impairment group were significantly higher than those in the cognitive normal group and the control group,and the level in the cognitive normal group were significantly higher than those in the control group;the differences were statistically significant(P<0.05).The NHS3 score in the cognitive impairment group was(14.25±3.75)points,which was significantly higher than(10.08±3.16)points in the cognitive normal group(P<0.05).Pearson correlation analysis showed that AQP4 was positively correlated with MoCA scores(r=0.528,P<0.05)and negatively correlated with NHS3 scores(r=

关 键 词：癫痫 认知功能 水通道蛋白4 神经丝轻链蛋白 B细胞活化因子 相关性 

分 类 号：R742.1[医药卫生—神经病学与精神病学]