血清NSE、NPY及GAL水平与成人癫痫持续状态的关系及临床意义

Relationship between serum NSE,NPY and GAL levels and status of adult epilepsy and its clinical significance

目的探究成年癫痫患者血清中特异性烯醇化酶(NES)、神经肽(NPY)及甘丙肽(GAL)水平与癫痫持续状态的关系以及其临床意义。方法选取2017年6月~2018年12月上海市静安区精神卫生中心住院部因持续性癫痫入院的成人患者56例(癫痫组);另选取同时期50例门诊体检健康成人血清标本(健康组),采集癫痫患者入院时血清以及持续性癫痫发作后24 h内血清,使用ELISA法检测血清NSE、NPY及GAL水平并进行比较。脑电图检查观察癫痫患者脑电图异常状况。并分析癫痫患者血清中NSE、NPY及GAL水平与其脑电图异常程度以及癫痫持续状态的关系。结果癫痫患者血清中NSE、NPY及GAL水平[(6.95±1.16)μg/L、(224.52±27.88)ng/L、(109.63±7.54)ng/L]明显高于健康组[(3.83±1.25)μg/L、(176.68±25.42)ng/L、(84.26±8.96)ng/L],差异有统计学意义(P<0.05);持续性癫痫发作后患者血清中NSE、NPY及GAL水平[(10.01±1.47)μg/L、(307.09±32.24)ng/L、(142.56±8.16)ng/L],明显高于癫痫发作前癫痫患者,差异有统计学意义(P<0.05)。癫痫患者中脑电图正常、轻度异常、中度异常和重度异常比例分别为17.86%、28.57%、39.29%和14.29%,且随着脑电图异常严重程度升高,其血清中NSE、NPY及GAL水平亦升高,差异有统计学意义(P<0.05)。Spearman's相关分析结果显示,癫痫患者血清中NSE、NPY及GAL水平与其脑电图异常严重程度度以及癫痫持续状态均正相关(P<0.05)。结论成人血清中NSE、NPY及GAL水平与癫痫发病以及脑电图异常程度有着密切关系,临床上可联合检测结果作为癫痫病情评价指标参考指标。

Objective To investigate the relationship between serum NSE,NPY and GAL levels and epilepsy status in adult patients with epilepsy and its clinical significance.Methods From June 2017 to December 2018,56 cases of adult patients diagnosed with epilepsy were enrolled in this study.The serum samples of patients with epilepsy were collected at admission and 24h after admission.Another 50 serum samples of healthy adults were collected at the same period.The levels of serum NSE,NPY and GAL were detected by ELISA.Electroencephalogram examination was conducted to observe the abnormal status of electroencephalogram in epileptic patients.The relationship between levels of serum NSE,NPY and GAL and the degree of eeg abnormalities was analyzed in epileptic patients.The relationship between levels of serum NSE,NPY and GAL and the status of epilepsy was analyzed in epileptic patients.Results The serum levels of NSE,NPY and GAL in patients with epilepsy were significantly higher than those in healthy adults(P<0.05).The levels of serum NSE,NPY and GAL in patients with epilepsy were significantly higher than those in patients with epilepsy before epileptic seizures(P<0.05).The proportion of normal,mildly abnormal,moderately abnormal and severely abnormal electroencephalogram in epileptic patients was 17.86%,28.57%,39.29%and 14.29%respectively,and the serum levels of NSE,NPY and GAL increased with the increase of the severity of electroencephalogram(P<0.05).Spearman's correlation analysis results showed that the serum levels of NSE,NPY and GAL were positively correlated with the severity of electroencephalogram abnormalities and the status of epilepsy(P<0.05).Conclusion The serum levels of NSE,NPY and GAL in adults are closely related to the occurence of epilepsy and the degree of electroencephalogram abnormalities,and the clinical results of combined detection can be used as reference index for the evaluation of epilepsy severity.