常规脑电图联合血清miR-146a、miR-129-5p水平检测对药物难治性癫痫的临床诊断价值  

Clinical value of routine electroencephalogram combined with serum miR-146a and miR-129-5p levels in diagnosis of drug-resistant epilepsy patients

作　　者：吴美娜 戴为正 潘毓敦 傅懋林 陈晓瑜 WU Meina;DAI Weizheng;PAN Yudun;FU Maolin;CHEN Xiaoyu(Department of Neurology,the 910th Hospital of Joint Logistic Support Force,Quanzhou 362000,China;Department of Imaging,the First Hospital of Quanzhou)

机构地区：[1]联勤保障部队第910医院神经内科,362000 [2]泉州市第一医院影像科

出　　处：《天津医药》2024年第11期1207-1211,共5页Tianjin Medical Journal

摘　　要：目的探究常规脑电图联合血清miR-146a、miR-129-5p水平检测对药物难治性癫痫的临床诊断价值。方法将2021年6月—2023年6月收治的60例难治性癫痫患者纳入难治性癫痫组,40例健康志愿者纳入对照组。体外培养连续暴露于苯妥英钠的人脑微血管内皮耐药细胞作为耐药组,分别转染miR-NC、miR-146a模拟物和miR-129-5p模拟物,记作miR-NC组、miR-129-5p模拟物组和miR-146a模拟物组。采用蛋白质印迹检测各组细胞和血液中高迁移率族蛋白B1(HMGB1)蛋白表达。采用荧光定量聚合酶链式反应检测血清miR-146a和miR-129-5p水平,WB检测血清HMGB1蛋白表达。以多名专家医师的综合问诊结果为金标准,评估常规脑电图和血清miR-146a、miR-129-5p水平检测以及联合检测对难治性癫痫患者的诊断价值,并绘制受试者工作特征(ROC)曲线。结果与对照组相比,耐药组细胞的HMGB1表达下降;与miR-NC组相比,miR-129-5p模拟物组和miR-146a模拟物组细胞的HMGB1表达下降(P<0.05)。与对照组相比,难治性癫痫组血清HMGB1蛋白表达下调,miR-146a和miR-129-5p表达上调。ROC曲线分析显示,常规脑电图联合血清miR-146a和miR-129-5p水平诊断难治性癫痫的曲线下面积、敏感度、特异度和准确度高于单一检测。结论常规脑电图和血清miR-129-5p、miR-146a水平联合检测可为临床上药物难治性癫痫的诊断提供帮助。Objective To investigate the clinical diagnostic value of routine electroencephalogram(EEG)combined with serum miR-146a and miR-129-5p levels in drug-resistant epilepsy.Methods Sixty patients with refractory epilepsy admitted to our hospital from June 2021 to June 2023 were included in the refractory epilepsy group,and 40 healthy volunteers were included in the control group.Human microvascular endothelial drug-resistant cells(HBMECs)continuously exposed to PHT2 were cultured in vitro and transfected with miR-NC(the miR-NC group),miR-146a mimics(the miR-146a mimics group)and miR-129-5p mimics(the miR-129-5p mimics group),respectively.Western blod assay was used to detect the expression of high-mobility group protein B1(HMGB1)in each group.Serum miR-146a and miR-129-5p levels were detected by fluorescent quantitative PCR(polymerase chain reaction),and serum HMGB1 protein expression was detected by Western blod assay.The sensitivity,specificity and accuracy of routine EEG,serum miR-146a and miR-129-5p levels and combined diagnosis of drug-resistant epilepsy were evaluated using the comprehensive consultation results of several expert physicians as the gold standard,and ROC curves were drawn.Results Compared with the control group,the expression of HMGB1 was significantly decreased in the drug-resistant group.Compared with the miR-NC group,HMGB1 expression was significantly decreased in the miR-129-5p mimics group and the miR-146a mimics group(P<0.05).Compared with the healthy group,the serum HMGB1 protein expression was down-regulated and miR-146a and miR-129-5p expression levels were significantly up-regulated in the refractory epilepsy group.ROC curve analysis indicated that the area under the curve,sensitivity,specificity and accuracy of conventional EEG combined with serum miR-146a and miR-129-5p levels were higher in the diagnosis of refractory epilepsy than that of single diagnostic method.Conclusion The combination of routine EEG and serum miR-129-5p and miR-146a levels can provide help for the diagnosis of

关 键 词：耐药性癫痫 脑电描记术 微RNAS ROC曲线 HMGB1蛋白质 MIR-146A miR-129-5p 药物难治性癫痫 

分 类 号：R742.1[医药卫生—神经病学与精神病学]