首治癫痫患儿脑电图与血清α-突触核蛋白和tau蛋白表达的相关性

Correlation between EEG and serumα-synuclein and Tau protein expression in children with first-treatment epilepsy

目的探讨α-突触核蛋白(α-syn)和tau蛋白在癫痫患儿血清中的表达水平,并分析其与脑电图的相关性。方法选取2019年2月-2020年4月因癫痫在天津市安定医院接受治疗的94例患儿(均为首治患儿)为癫痫组,另选取同期92例健康体检儿童作为对照组。采用酶联免疫吸附(ELISA)法检测患儿血清α-syn和tau蛋白水平;采用脑电图仪对受试儿童进行脑电图检查;采用Pearson法和Spearman法分析癫痫患儿脑电图异常率和脑电图放电指数与血清α-syn和tau蛋白水平的相关性。结果癫痫组患儿发作1 h和发作24 h血清α-syn[(13.13±2.98)μg/L、(12.94±2.21)μg/L]、tau蛋白[(16.54±3.76)pg/ml、(15.88±2.39)pg/ml]水平及脑电图放电指数[(63.14±10.65)%、(62.81±10.16)%]均高于对照组[(5.76±1.43)μg/L、(5.02±1.38)pg/ml及(41.79±7.62)%],差异均有统计学意义(F=308.987、531.912及151.005,均P<0.05);发作24 h血清α-syn、tau蛋白水平及脑电图放电指数与发作1 h比较,差异均无统计学意义(t=0.497、1.436及0.231,均P>0.05)。发作1 h脑电图异常率(79.79%)高于发作24 h(67.02%),差异有统计学意义(χ^(2)=3.923,P<0.05)。对照组脑电图均正常;癫痫组患儿发作1 h时19例脑电图正常,48例表现为尖波、棘波及棘(尖)-慢综合波,27例表现为非阵发性出现的局灶或广泛δ及θ活动;癫痫组患儿发作24 h时31例脑电图正常,42例表现为尖波、棘波及棘(尖)-慢综合波,21例表现为非阵发性出现的局灶、广泛δ及θ活动。发作1 h和发作24 h脑电图异常组血清α-syn[(16.85±3.14)μg/L、(20.52±3.89)μg/L]和tau蛋白[(15.76±2.81)pg/ml、(18.96±3.64)pg/ml]水平均高于脑电图正常组[(9.54±1.31)μg/L、(13.03±2.81)μg/L,(9.31±1.16)pg/ml及(12.61±2.92)pg/ml],差异均有统计学意义(t=9.899、7.874、12.250及8.458,均P<0.05)。癫痫患儿发作1 h和发作24 h血清α-syn与tau蛋白水平均呈正相关关系(r=0.637、0.677,均P<0.05);癫痫患儿发作24 h脑电图异常率和脑电图放电指数与血清α-syn和tau蛋白水平均呈正相关关系(r=0.534、0.513、0.516及0.524,均P<0.05)。结论癫痫患儿血清α-syn和tau蛋白水平呈高表达,且二者与脑电图异常率和脑电图放电指数均呈正相关关系。

Objective To investigate the expression levels ofα-synuclein(α-syn)and tau in serum of children with epilepsy,and to analyze their correlation with electroencephalogram(EEG).Methods A total of 94 children with epilepsy who were treated in Tianjin Anding Hospital from February 2019 to April 2020(all the children were with first-treatment epilepsy)were selected as the epilepsy group,and 92 healthy children with physical examination during the same period were selected as the control group.Serum levels ofα-syn and tau were detected by enzyme-linked immunosorbent assay(ELISA).The children were examined by electroencephalogram(EEG).The correlation of abnormal rate of EEG and EEG discharge index with serumα-syn and Tau protein levels in children with epilepsy was analyzed by Pearson method and Spearman method.Results The children in the epilepsy group had seizures for 1 h and 24 h serum levels ofα-syn[(13.13±2.98)μg/L,(12.94±2.21)μg/L],tau protein[(16.54±3.76)pg/ml,(15.88±2.39)pg/ml]and EEG discharge index[(63.14±10.65)%,(62.81±10.16)%]were higher than those in the control group[(5.76±1.43)μg/L,(5.02±1.38)pg/ml and(41.79±7.62)%],and the differences were statistically significant(F=308.987,531.912 and 151.005,all P<0.05).There were no significant differences in serumα-syn and tau protein levels and EEG discharge index at 24 h after seizure compared with 1 h after seizure(t=0.497,1.436 and 0.231,all P>0.05).The abnormal rate of EEG at 1 h(79.79%)was higher than that at 24 h(67.02%),and the difference was statistically significant(χ^(2)=3.923,P<0.05).The EEG of the control group was normal.In the epilepsy group,19 cases showed normal EEG,48 cases showed sharp wave,spinous wave and spine-slow complex wave,and 27 cases showed nonparoxytic focal or extensiveδandθactivity.At 24 h after seizure,31 cases of epilepsy group showed normal EEG,42 cases showed sharp wave,spinous wave and spinous(sharp)-slow complex wave,and 21 cases showed nonparoxytic focal and extensiveδandθactivity.Serumα-syn in patients with abnormal EEG at 1 h and 24 h after seizure[(16.85±3.14)μg/L,(20.52±3.89)μg/L]and tau protein levels[(15.76±2.81)pg/ml,(18.96±3.64)pg/ml]were higher than those in normal EEG group[(9.54±1.31)μg/L,(13.03±2.81)μg/L,(9.31±1.16)pg/ml and(12.61±2.92)pg/ml],the differences were statistically significant(t=9.899,7.874,12.250 and 8.458,all P<0.05).There was a positive correlation between serumα-syn and tau protein levels at 1 h and 24 h after seizure(r=0.637,0.677,all P<0.05).The abnormal rate of EEG and EEG discharge index at 24 h after seizure were positively correlated with the serum levels ofα-syn and tau(r=0.534,0.513,0.516 and 0.524,all P<0.05).Conclusion Serumα-syn and tau protein levels were highly expressed in children with epilepsy,and they were positively correlated with the abnormal rate of EEG and the discharge index of EEG.