惊厥患儿血清学NSE IGF-1浓度水平变化及临床意义

Changes of serum levels of NSE and IGF-1 in children with convulsion and the clinical significance

目的探讨小儿惊厥发作后血清中神经元特异性烯醇化酶(NSE)和胰岛素样生长因子-1(IGF-1)表达水平及临床意义。方法选取2017年10月-2019年8月在承德医学院附属医院就诊的120例惊厥患儿按照发作病因分为热性惊厥组60例和癫痫组60例,同时选取54例同期正常体检的非惊厥儿童作为对照组。应用ELISA方法和放射免疫分析法分别对所有研究对象(患儿惊厥发作后)血清中的NSE和IGF-1进行检测,并分析血清中NSE和IGF-1水平在不同程度惊厥发作中的诊断价值。结果热性惊厥组患儿血清中NSE水平均高于对照组儿童,癫痫组患儿显著高于热性惊厥组患儿,惊厥发作持续时间≥5 min组高于惊厥发作持续时间<5 min组且均较对照组高,惊厥发作次数≥3次组高于惊厥发作次数<3次组且均较对照组高,差异均有统计学意义(P<0.05)。热性惊厥组患儿血清中IGF-1水平均低于对照组儿童,癫痫组患儿低于热性惊厥组患儿,惊厥发作持续时间≥5 min组低于惊厥发作持续时间<5 min组且均较对照组低,惊厥发作次数≥3次组的患儿低于惊厥发作次数<3次组的患儿,差异均有统计学意义(P<0.05)。惊厥患儿血清中IGF-1和NSE呈负相关(R=-0.436,P<0.05),血清NSE、IGF-1的ROC曲线下面积(AUC)分别为0.895、0.666。结论惊厥发作后血清NSE、IGF-1共同参与了惊厥发生的过程,并与惊厥发作的类型与发作严重程度密切相关,对临床诊断惊厥后脑损伤具有重要的临床意义。

Objective To explore the expression levels and clinical significance of serum neuron-specific enolase(NSE)and insulinlike growth factor-1(IGF-1)in children with convulsion.Methods From October 2017 to August 2019,120 children with convulsion treated in Chengde Medical College were selected and divided into febrile convulsion group and epilepsy group according to the causes of attack,60 children in each group,54 children without convulsion during the same period were selected as control group.ELISA and radioimmunoassay were used to detect the levels of serum NSE and IGF-1 in the three groups.The diagnostic value of serum NSE and IGF-1 levels in different degrees of seizure was analyzed.Results The level of serum NSE in febrile convulsion group was higher than that in control group,the level of serum NSE in epilepsy group was higher than that in febrile convulsion group,the level of serum NSE in convulsion duration time≥5 minutes group was higher than that in convulsion duration time<5 minutes group,the levels of serum NSE in convulsion duration time≥5 minutes group and convulsion duration time<5 minutes group were higher than that in control group,the level of serum NSE in convulsion onset≥3 times group was higher than that in convulsion onset<3 times group,the levels of serum NSE in convulsion onset≥3 times group and convulsion onset<3 times group were higher than that in control group,there were statistically significant differences(P<0.05).The level of serum IGF-1 in febrile convulsion group was lower than that in control group,the level of serum IGF-1 in epilepsy group was lower than that in febrile convulsion group,the level of serum IGF-1 convulsion duration time≥5 minutes group was lower than that in convulsion duration time<5 minutes group,the level of serum IGF-1 in convulsion onset≥3 times group was lower than that in convulsion onset<3 times group,there were statistically significant differences(P<0.05).There was a negative correlation between serum IGF-1 and serum NSE in children with convulsion(R=-0.436,P<0.05),the areas under ROC curve of serum NSE and IGF-1 were 0.895 and 0.666,respectively.Conclusion Serum NSE and IGF-1 participate in the process of convulsion,the two indexes are closely related to the type and severity of convulsion,which is of great clinical significance for clinical diagnosis of brain injury after convulsion.