血清神经元特异性烯醇化酶及肿瘤坏死因子-α水平与病毒性脑炎继发性癫痫患儿预后的关系  

Relationship between the levels of serum neuron-specific enolase,tumor necrosis factor-αand the prognosis of children with epilepsy secondary to viral encephalitis

作　　者：吉沛 孙丽君[2] 徐红梅 侯春梅 JI Pei;SUN Lijun;XU Hongmei;HOU Chunmei(Department of Neurology,People′s Hospital Affiliated to Inner Mongolia Medical University,Hohhot 010010,Inner Mongolia,China;Department of Neurology,the Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010020,Inner Mongolia,China;Department of Pediatrics,the Fourth Affiliated Hospital of Baotou Medical College,Baotou 014046,Inner Mongolia,China;Department of Pediatrics,People′s Hospital Affiliated to Inner Mongolia Medical University,Hohhot 010010,Inner Mongolia,China)

机构地区：[1]内蒙古医科大学附属人民医院/内蒙古自治区肿瘤医院神经内科,内蒙古呼和浩特010010 [2]内蒙古医科大学附属医院神经内科,内蒙古呼和浩特010020 [3]包头医学院第四附属医院儿科,内蒙古包头014046 [4]内蒙古医科大学附属人民医院/内蒙古自治区肿瘤医院儿科,内蒙古呼和浩特010010

出　　处：《新乡医学院学报》2024年第10期962-967,共6页Journal of Xinxiang Medical University

基　　金：内蒙古自治区卫生健康委员科研项目(编号:20190095)。

摘　　要：目的探讨血清神经元特异性烯醇化酶(NSE)、肿瘤坏死因子-α(TNF-α)水平与病毒性脑炎(VE)患儿继发性癫痫发作期及其与预后的关系。方法选择2015年1月至2020年1月内蒙古医科大学附属人民医院收治的96例VE患儿为研究对象,根据脑电图检查结果分为对照组(单纯VE患儿,n=30)和观察组(VE继发性癫痫患儿,n=66)。另选择同期在医院进行体检的30例健康儿童作为健康组。比较健康组、对照组、观察组受试者血清NSE、TNF-α水平。根据入院后24 h内是否再次发作将观察组患儿分为24 h内再发作组(n=48)和24 h内未再发作组(n=18),比较2组患儿血清NSE、TNF-α水平,并采用Pearson相关性分析NSE、TNF-α水平与VE继发性癫痫患儿发作期的关系。根据出院时儿童格拉斯哥预后量表评分将观察组患儿分为预后良好组(n=45)和预后不良组(n=21),比较2组患儿血清NSE、TNF-α水平及其他可能影响预后的因素,采用多因素logistic回归分析影响VE继发性癫痫患儿预后的相关因素,并绘制受试者操作特征曲线分析血清NSE、TNF-α对VE继发性癫痫患儿预后的预测价值。结果对照组患儿血清NSE水平显著高于健康组(P<0.05);对照组与健康组受试者血清TNF-α水平比较差异无统计学意义(P>0.05);观察组患儿血清NSE、TNF-α水平显著高于健康组和对照组(P<0.05)。24 h内再发作组患儿血清NSE、TNF-α水平显著高于24 h内未再发作组(P<0.05)。预后良好组患儿脑电图重度异常、头颅影像学重度异常、合并呼吸衰竭占比及血清C反应蛋白、NSE、TNF-α水平均低于预后不良组(P<0.05);2组患儿的性别、年龄、体质量、脑损伤部位、发热、低钾血症、低钠钾症、既往抽搐、应激性高血糖、合并脏器功能损伤、病毒感染情况、首发癫痫、入院时格拉斯哥昏迷量表评分、抽搐持续时间、住院时间、白细胞计数及天冬氨酸转氨酶、肌酸激酶、心肌肌钙蛋�Objective To investigate the relationship between the levels of serum neuron-specific enolase(NSE)and tumor necrosis factor alpha(TNF-α)and the attack stage and prognosis of children with epilepsy secondary to viral encephalitis(VE).Methods A total of 96 children with VE admitted to the People′s Hospital Affiliated to Inner Mongolia Medical University from January 2015 to January 2020 were selected as the research subjects,and they were divided into the control group(children with VE,n=30)and the observation group(children with epilepsy secondary to VE,n=66).In addition,30 healthy children who underwent physical examination in the hospital during the same period were selected as the health group.The levels of serum NSE and TNF-αin the health group,control group and observation group were compared.Children in the observation group were further divided into the 24h relapse group(n=48)and 24h non-relapse group(n=18)according to the attack of disease within 24h after admission.The levels of serum NSE and TNF-αwere compared between the two groups.Pearson correlation was used to analyze the relationship between the levels of NSE,TNF-αand the attack stage of epilepsy secondary to VE.Children in the observation group were divided into the good prognosis group(n=45)and the poor prognosis group(n=21)according to the Glasgow Outcome Scale score at discharge.The serum levels of NSE,TNF-αand other possible prognostic factors were compared between the two groups.Multivariate logistic regression analysis was used to explore the prognostic factors of children with epilepsy secondary to VE,and the predictive value of serum NSE and TNF-αlevels on the prognosis of children with epilepsy secondary to VE was analyzed by drawing the receiver operating characteristic curve.Results The level of serum NSE in the control group was significantly higher than that in the health group(P<0.05),and there was no significant difference in the level of serum TNF-αbetween the control group and the health group(P>0.05).The serum levels of N

关 键 词：病毒性脑炎 继发性癫痫 神经元特异性烯醇化酶 肿瘤坏死因子-Α 

分 类 号：R512.3[医药卫生—内科学]