癫痫患者血清Netrin-1、NGF水平、脑电图异常与认知功能的关系  

The relationship between serum Netrin-1, NGF levels, EEG abnormalities and cognitive function in epilepsy patients

作　　者：汤文郁 刘哲 马轩 潘建萍 Tang Wenyu;Liu Zhe;Ma Xuan;Pan Jianping(Department of Neurology,Xi'an International Medical Center Hospital,Shaanxi,Xi'an 710100,China;不详)

机构地区：[1]西安国际医学中心医院神经内八科,710100 [2]西安国际医学中心医院影像科,710100

出　　处：《疑难病杂志》2025年第4期445-449,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：国家自然科学基金项目(82171181)。

摘　　要：目的探究癫痫患者血清神经轴突导向因子(Netrin-1)、神经生长因子(NGF)、脑电图异常与认知功能的关系。方法选取2022年3月—2024年5月西安国际医学中心医院神经内八科诊治的癫痫患者316例作为病例组,采用蒙特利尔认知评估量表(MoCA)评估癫痫患者认知功能,并分为非认知障碍(NCDs)亚组141例和认知障碍(CDs)亚组175例,另选取同期健康体检者280例作为健康对照组。采用酶联免疫吸附(ELISA)法检测血清Netrin-1、NGF水平,应用脑电图仪检查癫痫患者脑电图异常程度;采用Spearman法分析血清Netrin-1、NGF水平、脑电图检测与MoCA评分的相关性。绘制受试者工作特征(ROC)曲线评估血清Netrin-1、NGF水平及脑电图异常预测癫痫患者认知功能不良的价值。结果与健康对照组比较,病例组血清Netrin-1水平升高,血清NGF水平降低(t=34.511/<0.001,11.727/<0.001)。健康对照组未出现脑电图异常,病例组患者出现脑电图异常285例(90.19%)。血清Netrin-1水平随患者脑电图异常程度的加重依次升高,血清NGF水平依次降低(F=113.23/<0.001,31.290/<0.001)。CDs亚组血清Netrin-1水平高于NCDs亚组,血清NGF水平低于NCDs亚组(t=12.594/<0.001,5.584/<0.001)。CDs亚组MoCA评分总分低于NCDs亚组(t/P=26.572/<0.001)。MoCA评分与癫痫患者血清Netrin-1水平呈负相关,与血清NGF水平呈正相关,与癫痫发作患者脑电图异常情况呈负相关(r=-0.452、0.497、-0.507、P均<0.01)。血清Netrin-1、NGF水平、脑电图异常及三者联合预测癫痫患者认知功能不良的AUC分别为0.846、0.728、0.552、0.908,三者联合优于各自单独预测效能(Z/P=3.988/<0.001,6.929/<0.001,16.109/<0.001)。结论CDs癫痫患者血清Netrin-1水平异常升高,NGF水平异常降低,且癫痫患者的MoCA评分与血清Netrin-1、NGF水平及脑电图异常程度密切相关。血清Netrin-1、NGF水平及脑电图异常三者联合预测癫痫患者认知功能障碍的效能较高。Objective To investigate the relationship between serum Netrin-1,nerve growth factor(NGF),electroencephalogram(EEG)abnormalities and cognitive function in epilepsy patients.Methods A total of 316 epilepsy patients diagnosed and treated in the Department of Neurology VIII of Xi'an International Medical Centre Hospital from March 2022 to May 2024 were selected as a case group,and the cognitive function of epilepsy patients was assessed by Montreal Cognitive Assessment Scale(MoCA),of which 141 were classified into the subgroup of non-cognitively impaired NCDs,and 175 were classified into the subgroup of cognitively impaired CDs,and 280 cases of those who had a health check-up were selected during the same period as a control group.The enzyme-linked immunosorbent assay(ELISA)method was used to detect serum Netrin-1 and NGF levels,and an electroencephalograph was used to examine the degree of EEG abnormalities in patients with epilepsy.Spearman method was applied to analyze the correlation between serum Netrin-1,NGF levels,electroencephalogram detection,and MoCA score.The value of plotting subjects'work characteristic curve(ROC)curves to assess serum Netrin-1,NGF levels and EEG abnormalities in predicting cognitive dysfunction in patients with epilepsy.Results Compared with the control group,the serum Netrin-1 level in the case group was increased,and the serum NGF level was decreased(t=34.511,11.727,P<0.001).There were no EEG abnormalities in the control group,and 285(90.19%)patients in the case group had EEG abnormalities.Serum Netrin-1 level increased with the severity of EEG abnormality,and serum NGF level decreased with the severity(F=113.23,31.29,P<0.001).The serum Netrin-1 level in CDs subgroup was higher than that in NCDs subgroup,and the serum NGF level was lower than that in NCDs subgroup(t=12.594,5.584,P<0.001).The total MoCA score of NCDs subgroup was higher than that of CDs subgroup(t=26.572,P<0.001).MoCA score was negatively correlated with serum Netrin-1 level in epileptic patients,positively correlated

关 键 词：癫痫 神经轴突导向因子 神经生长因子 脑电图异常 认知功能 

分 类 号：R742.1[医药卫生—神经病学与精神病学]