血清HIF-1α、GFAP表达与脑卒中后继发性癫痫的相关性

Correlation between serum HIF-1α and GFAP expression and secondary epilepsy after stroke

目的 探讨血清低氧诱导因子-1α(HIF-1α)、胶质纤维酸性蛋白(GFAP)表达与卒中后继发性癫痫的关系。方法选取2018年5月至2020年5月芜湖市第五人民医院就诊的卒中后继发癫痫患者73例为癫痫组,卒中后未发生癫痫患者88例为非癫痫组。对比两组患者基础资料及血清HIF-1α、GFAP水平差异,分析脑卒中继发癫痫的危险因素,观察HIF-1α、GFAP检测对脑卒中继发癫痫的预测价值。结果73例继发性癫痫患者中早发性癫痫29例(39.73%),迟发性癫痫44例(60.27%)。癫痫组和非癫痫组患者入院NIHSS评分、病灶部位及卒中范围差异有统计学意义(P<0.05),癫痫组患者血清HIF-1α、GFAP水平显著高于无癫痫组(P<0.05)。Logistic回归分析显示,NIHSS评分(中、重度)、病灶累及皮质、多脑叶病灶及血清HIF-1α、GFAP高表达是卒中后继发癫痫的危险因素(P<0.05)。血清HIF-1α联合GFAP预测卒中后继发癫痫的曲线下面积(AUC)为0.914,敏感度为83.6%、特异度为86.4%。结论HIF-1α、GFAP的表达与卒中后继发癫痫密切相关,检测血清HIF-1α及GFAP水平有助于预测卒中继发癫痫的风险。

Objective To investigate the relationship between serum HIF-1 α and GFAP expression and secondary epilepsy after stroke.Methods From May 2018 to May 2020 in our hospital,73 patients with post-stroke secondary epilepsy were selected as epilepsy group,and 88 patients without post-stroke epilepsy were selected as non-epilepsy group.The differences of basic data and serum HIF-1 α and GFAP levels between the two groups were compared.The risk factors of stroke secondary epilepsy were analyzed.The predictive value of HIF-1αand GFAP detection in stroke secondary epilepsy were observed.Results Among 73 cases of secondary epilepsy,29 cases(39.73%) were early onset epilepsy,44 cases(60.27%) were late onset epilepsy.There were statistically significant differences in NIHSS score,lesion location and stroke range between epilepsy group and non-epilepsy group(P<0.05).The serum HIF-1α and GFAP levels in epilepsy group were significantly higher than those in non-epilepsy group(P<0.05).Logistic regression analysis showed that NIHSS score(moderate and severe),focal cortical involvement,multi-lobe lesions and high expression of HIF-1α and GFAP were risk factors for secondary epilepsy after stroke(P<0.05).The area under curve(AUC) of serum HIF-1α combined with GFAP was 0.914,the sensitivity was 83.6% and the specificity was 86.4%.Conclusion The expression of HIF-1α and GFAP is closely related to the secondary epilepsy after stroke,and detection of serum HIF-1 α and GFAP levels can predict the risk of secondary epilepsy after stroke.