血清炎症因子-铁代谢途径与癫痫患者停药后复发的交互作用  

Interaction of serum inflammatory factor-iron metabolic pathway and relapse in epilepsy patients after drug withdrawal

作　　者：宋晓园 晁艳艳 SONG Xiaoyuan;CHAO Yanyan(Handan Central Hospital,Handan 056008,China)

机构地区：[1]邯郸市中心医院,河北邯郸056008

出　　处：《中国实用神经疾病杂志》2025年第3期341-345,共5页Chinese Journal of Practical Nervous Diseases

基　　金：邯郸市科学技术研究与发展计划项目(编号:19422083009-3)。

摘　　要：目的分析血清炎症因子-铁代谢途径与癫痫患者停药后复发的交互作用。方法选取2018-06—2021-06邯郸市中心医院治疗的213例拟停药癫痫患者为研究对象,在完全停用抗癫痫药物后以门诊的方式随访1 a,根据随访结果分为复发组和未复发组。检测受试者血清炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)]和铁代谢(铁蛋白、血清铁、总铁结合力)水平。采用Logistic回归分析影响癫痫患者停药后复发的危险因素,采用Spearman相关性分析血清TNF-α、IL-1β、IL-6、铁蛋白、血清铁、总铁结合力水平与癫痫患者停药后复发的相关性。结果213例患者中201例在1 a内完全停药成功,停药成功率94.37%(201/213)。201例患者中13例失访,失访率6.47%(13/201),188例获得完整随访记录,其中56例在随访期间复发,复发率29.79%(56/188)。复发组发病年龄>18岁、治疗前发作频率>5次/a占比、病程及TNF-α、IL-1β、IL-6、铁蛋白、总铁结合力水平高于未复发组(P<0.05),血清铁水平低于未复发组(P<0.05)。Logistic回归分析显示发病年龄>18岁、治疗前发作频率>5次/a、病程及TNF-α、IL-1β、IL-6、铁蛋白、总铁结合力、血清铁水平异常是影响癫痫患者停药后复发的危险因素(P<0.05)。血清TNF-α、IL-1β、IL-6、铁蛋白、总铁结合力水平与癫痫患者停药后复发呈正相关(P<0.05),血清铁水平与癫痫患者停药后复发呈负相关(P<0.05)。结论癫痫患者停药后复发率较高,癫痫复发患者中血清TNF-α、IL-1β、IL-6、铁蛋白、总铁结合力水平表达较高,血清铁表达降低,且与癫痫复发存在明显的相关性。血清炎症因子-铁代谢途径紊乱可能诱导癫痫患者停药后复发,临床可通过改善上述途径降低癫痫复发率。Objective To analyze the interaction between serum inflammatory factor-iron metabolism pathway and relapse of epilepsy patients after drug withdrawal.Methods From June 2018 to June 2021,213 patients with epilepsy of Handan Central Hospital were selected as the study objects.The patients were followed up for 1 year after discontinuing antiepileptic drugs.According to the follow-up results,the patients were divided into relapse group and non-relapse group.Serum inflammatory factors(tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6))and iron metabolism(ferritin,serum iron,total iron binding capacity)were measured.Logistic regression analysis was used to analyze the risk factors affecting relapse after drug withdrawal in patients with epilepsy,and Spearman correlation analysis was used to analyze the correlation among serum TNF-α,IL-1β,IL-6,ferritin,serum iron,total iron binding capacity and relapse after drug withdrawal in patients with epilepsy.Results Among the 213 patients,201 cases successfully stopped the drug at 1-year,and the success rate was 94.37%(201/213).During the follow-up,13 cases were lost to follow-up,with a loss rate of 6.47%(13/201).Complete follow-up records were obtained for 188 patients,among whom 56 cases relapsed during follow-up,with a recurrence rate of 29.79%(56/188).The onset age of recurrence group was>18 years old,the frequency of pre-treatment episodes was>5 times per year,the disease course,TNF-α,IL-1β,IL-6,ferritin and total iron binding capacity were higher than those of non-recurrence group(P<0.05),and the serum iron level was lower than that of non-recurrence group(P<0.05).Logistic regression analysis showed that age of onset>18 years old,frequency of seizures>5 times per year before treatment,course of disease,TNF-α,IL-1β,IL-6,ferritin,total iron binding capacity and abnormal serum iron level were risk factors for relapse after drug withdrawal in patients with epilepsy(P<0.05).Serum levels of TNF-α,IL-1β,IL-6,ferritin and total iron binding capaci

关 键 词：癫痫 炎症因子 铁代谢 停药后复发 交互作用 血清 

分 类 号：R742.1[医药卫生—神经病学与精神病学]