癫痫患儿血清基质金属蛋白酶-9、谷氨酸脱羧酶抗体、高迁移率族蛋白B1水平与左乙拉西坦治疗效果相关性及联合检测对治疗效果的预测价值  

Correlation of serum MMP-9,GADA,HMGB1 levels with therapeutic effect of levetiracetam in children with epilepsy,and predictive value of combined detection for therapeutic effect

作　　者：于乐 王沛 姜梦真 YU Le;WANG Pei;JIANG Mengzhen(Department of Pediatrics,Luohe Central Hospital,Luohe 462300,China)

机构地区：[1]漯河市中心医院儿科,河南漯河462300

出　　处：《陕西医学杂志》2025年第3期374-377,383,共5页Shaanxi Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20221083)。

摘　　要：目的:探讨癫痫患儿血清基质金属蛋白酶-9(MMP-9)、谷氨酸脱羧酶抗体(GADA)、高迁移率族蛋白B1(HMGB1)水平与左乙拉西坦治疗效果的相关性及联合检测对治疗效果的预测价值。方法:回顾性选取癫痫患儿98例为癫痫组,选取同期体检健康儿童98例为健康对照组,比较癫痫组与健康对照组入院时血清MMP-9、GADA、HMGB1水平。癫痫患儿均接受左乙拉西坦治疗,根据治疗1年后的疗效分为有效组(65例)和无效组(33例),比较有效组和无效组入院时和治疗1年后血清MMP-9、GADA、HMGB1水平。采用Spearman相关性分析入院时血清MMP-9、GADA、HMGB1水平与癫痫患儿左乙拉西坦治疗效果的相关性。采用受试者工作特征(ROC)曲线分析入院时血清MMP-9、GADA、HMGB1水平联合检测对癫痫患儿治疗效果的预测价值。结果:癫痫组入院时血清MMP-9、GADA、HMGB1水平高于健康对照组(均P<0.05)。有效组与无效组治疗1年后血清MMP-9、GADA、HMGB1水平低于治疗前,且有效组入院时和治疗1年后血清MMP-9、GADA、HMGB1水平低于无效组(均P<0.05)。癫痫患儿入院时血清MMP-9、GADA、HMGB1水平与左乙拉西坦治疗效果呈负相关(均P<0.05)。入院时血清MMP-9、GADA、HMGB1水平联合检测预测癫痫患儿左乙拉西坦治疗无效的曲线下面积(AUC)高于上述指标单项检测(均P<0.05)。结论:癫痫患儿入院时血清MMP-9、GADA、HMGB1水平较高,与左乙拉西坦治疗效果密切相关,早期联合检测可有效预测癫痫患儿左乙拉西坦治疗效果。Objective:To investigate the correlation of serum levels of matrix metalloproteinase-9(MMP-9),glutamate decarboxylase antibody(GADA),and high mobility group protein B1(HMGB1)with the therapeutic effect of levetiracetam in children with epilepsy,and the predictive value of combined detection for the therapeutic effect.Methods:A total of 98 children with epilepsy were retrospectively selected as epileptic group and 98 healthy children were selected as healthy control group,and serum levels of MMP-9,GADA and HMGB1 were compared between epileptic group and healthy control group at admission.All children with epilepsy received treatment with levetiracetam.After 1 year of treatment,98 children with epilepsy were divided into effective group(65 cases)and ineffective group(33 cases)based on the efficacy,and the serum levels of MMP-9,GADA and HMGB1 at admission and after 1 year of treatment were compared between the effective group and ineffective group.The correlation of serum levels of MMP-9,GADA,HMGB1 at admission with the therapeutic effect of levetiracetam in children with epilepsy was analyzed by Spearman correlation analysis.ROC curve was used to analyze the predictive value of combined detection of serum MMP-9,GADA,and HMGB1 levels at admission for the treatment effect of epilepsy in children.Results:The serum levels of MMP-9,GADA and HMGB1 in the epilepsy group were significantly higher than those in the healthy control group at admission(all P<0.05).After 1 year of treatment,the serum levels of MMP-9,GADA and HMGB1 in the effective group and ineffective group were lower than before treatment,and the serum levels of MMP-9,GADA,and HMGB1 in the effective group were lower than those in the ineffective group at admission and after 1 year of treatment(all P<0.05).The serum levels of MMP-9,GADA and HMGB1 in children with epilepsy were negatively correlated with the therapeutic effect of levetiracetam at admission(all P<0.05).The AUC of serum levels of MMP-9,GADA and HMGB1 combined detection at admission for prediction

关 键 词：癫痫 基质金属蛋白酶-9 谷氨酸脱羧酶抗体 高迁移率族蛋白B1 左乙拉西坦 预测价值 儿童 

分 类 号：R742.1[医药卫生—神经病学与精神病学]