老年IS患者血清Netrin-1水平与继发性癫痫的相关性分析

Correlation analysis between serum Netrin-1 level and secondary epilepsy in elderly patients with ischemic stroke

目的探究老年缺血性脑卒中(IS)患者血清轴突导向因子(Netrin-1)水平与继发性癫痫的相关性。方法选取2018年1月至2019年12月在北京朝阳区双桥医院神经内科收治的IS继发癫痫患者49例作为IS继发癫痫组,单一IS患者59例作为单一IS组。采用酶联免疫吸附测定法(ELISA)测定血清Netrin-1水平。根据脑电图检查将继发性癫痫组患者分为轻中重组三个亚组。分析血清Netrin-1与老年IS继发性癫痫患者脑电图严重程度关系。ROC法分析Netrin-1水平对老年IS发生继发性癫痫的诊断价值。对影响继发性癫痫发生的相关因素进行Logistic回归分析。结果IS继发癫痫组与单一IS组患者在入院时SSS评分、梗死面积、梗死部位上差异有统计学意义(P<0.05)。与轻度组相比,中度组、重度组IS继发癫痫患者血清Netrin-1水平较高(P<0.05);与中度组相比,重度组IS继发癫痫患者重度组血清Netrin-1水平较高(P<0.05)。ROC结果显示,Netrin-1水平诊断老年IS发生继发性癫痫的曲线下面积AUC为0.919,灵敏度为81.60%,特异度为88.10%。二元Logistic回归分析显示血清Netrin-1是影响老年IS患者继发性癫痫的危险因素。结论老年IS继发性癫痫患者血清中Netrin-1高表达,Netrin-1水平检测有利于老年IS患者发生继发性癫痫患者的筛选。

Objective To explore the correlation between the level of serum Netrin-1 and secondary epilepsy in elderly patients with ischemic stroke(IS).Methods From January 2018 to December 2019,49 patients with epilepsy secondary to IS in the Department of Neurology of our hospital were taken as secondary epilepsy group,and59 patients with single IS as the single IS group.The level of Netrin-1 in serum was determined by enzyme-linked immunosorbent assay(ELISA).According to the EEG,the patients in the secondary epilepsy group were divided into three subgroups:mild,moderate and severe groups.The relationship between serum Netrin-1 and the severity of EEG in elderly patients with recurrent epilepsy caused by IS was analyzed.The ROC method was used to analyze the diagnostic value of Netrin-1 level in secondary epilepsy in elderly patients with IS.Logistic regression analysis was used to analyze the related factors of secondary epilepsy.Results There were significant differences in SSS score,infarct area and infarct location at admission between the secondary epilepsy group and the single IS group(P<0.05).Compared with mild group,the level of serum Netrin-1 was higher in moderate group and severe group(P<0.05);compared with moderate group,the level of serum Netrin-1 was higher in severe group(P<0.05).ROC results show that The area under the curve for the diagnosis of secondary epilepsy in elderly patients with IS with Netrin-1 level was 0.919,the sensitivity was 81.60%,and the specificity was 88.10%.Binary Logistic regression analysis showed that serum Netrin-1 was a risk factor for secondary epilepsy in elderly patients with IS.Conclusions Netrin-1 is highly expressed in the serum of elderly patients with secondary epilepsy caused by IS.The detection of Netrin-1 level is conducive to the screening of secondary epilepsy in elderly patients with IS.