急性腹泻伴良性惊厥患儿血清NSE、H_2S、UCH-L1水平变化及对预测复发的临床价值分析  

Changes of serum NSE,H2S and UCH-L1 levels in children with acute diarrhea and benign convulsion and their clinical value on predicting recurrence

作　　者：杨贺伟 齐婷[1] 程瑶[1] 姚福军 YANG Hewei;QI Ting;CHENG Yao;YAO Fujun(Emergency Department,of Qinhuangdao,Qinhuangdao Hebei 066000,China)

机构地区：[1]秦皇岛市第一医院急诊科,河北秦皇岛066000

出　　处：《中国急救复苏与灾害医学杂志》2024年第8期1063-1066,1071,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：秦皇岛市科技支撑计划项目(编号:201805A019)。

摘　　要：目的 探讨急性腹泻伴良性惊厥患儿血清神经元特异性烯醇化酶(NSE)、硫化氢(H_(2)S)、泛素羧基末端水解酶L1(UCH-L1)水平变化及其对疾病复发的预测效能。方法 选择秦皇岛市第一医院2018年8月—2021年8月收治的急性腹泻伴良性惊厥的104例患儿进行前瞻性研究,另选同期于秦皇岛市第一医院行健康体检的30例健康儿童为对照组,所有儿童均取空腹静脉血检测血清NSE、H_(2)S、UCH-L1水平,并对比两组儿童及观察组不同病情患儿的血清NSE、H_(2)S、UCH-L1水平差异;观察组患儿随访2年以观察复发情况,对比有无复发患儿血清NSE、H_(2)S、UCH-L1水平差异,并采用受试者工作特征曲线(ROC)分析急性腹泻伴良性惊厥患儿血清NSE、H_(2)S、UCH-L1水平对复发的预测效能。结果 观察组血清NSE、UCH-L1水平明显高于对照组,H_(2)S水平明显低于对照组(P<0.05);相较于腹泻3~5次/d、惊厥发作1次、单次惊厥持续时间<5 min、惊厥局灶性发作的患儿,腹泻≥6次/d、惊厥发作≥2次、单次惊厥持续时间≥5 min、惊厥全面性发作患儿的血清NSE,UCH-L1水平均明显更高(P<0.05),血清H_(2)S水平明显更低(P<0.05);复发组患儿的血清NSE、UCH-L1水平明显高于未复发组(P<0.05),血清H_(2)S水平明显低于未复发组(P<0.05);ROC曲线分析显示,急性腹泻伴良性惊厥患儿血清NSE、H_(2)S、UCH-L1水平及联合检测均对复发有预测效能(P<0.05),其中单项检测时血清NSE对复发的预测效能较高,曲线下面积(AUC)为0.787,敏感为77.78%,特异度为81.05%;联合检测的预测效能最高,AUC为0.804,敏感性为88.89%,特异度为75.79%。结论 急性腹泻伴良性惊厥患儿的血清NSE、UCH-L1水平明显升高,血清H_(2)S水平降低,且与病情程度存在相关性,可用于预测惊厥复发。Objective To explore the changes of serum levels of neuron-specific enolase(NSE),hydrogen sulfide(H_(2)S)and ubiquitin carboxy-terminal hydrolase L1(UCH-L1)in children with acute diarrhea complicated with benign convulsion and their predictive efficiency on disease recurrence.Methods 104 children with acute diarrhea and benign convulsion admitted to our hospital from August 2018 to August 2021 were selected for a prospective study,and 30 healthy children who underwent physical examination in our hospital during the same period were included in control group.Fasting venous blood was taken to detect serum NSE,H_(2)S and UCH-L1 levels in all children.The differences in serum levels of NSE,H_(2)S and UCH-L1 were compared between both groups of children and among children with different disease conditions in observation group.All the children in observation group were followed up for 2 years to observe the recurrence situation,and the difference in serum NSE,H_(2)S and UCH-L1 levels were compared between children with or without recurrence.The predictive efficiency of serum NSE,H_(2)S and UCH-L1 levels on recurrence in children with acute diarrhea complicated with benign convulsion was analyzed by receiver operating characteristic curve(ROC).Results The levels of serum NSE and UCH-L1 in observation group were significantly higher than those in control group while the level of H_(2)S was significantly lower than that in control group(P<0.05).Serum NSE and UCH-L1 levels were significantly higher in children with diarrhea≥6 times/day,convulsion attack≥twice,single convulsion duration≥5 min and generalized convulsion attack than those in children with diarrhea of 3-5 times/day,once convulsion attack,single convulsion duration<5 min and focal convulsion attack(P<0.05),while serum H_(2)S level was significantly lower(P<0.05).The levels of serum NSE and UCH-L1 in recurrence group were significantly higher than those in non-recurrence group(P<0.05)while the level of serum H_(2)S was significantly lower than that in nonr

关 键 词：急性腹泻 惊厥 患儿 神经元特异性烯醇化酶 硫化氢 泛素羧基末端水解酶L1 

分 类 号：R720.597[医药卫生—急诊医学]