血清NSE、HSP70与AEEG在小儿复杂性热性惊厥中的变化及其与继发癫痫的相关性

Changes of serum NSE,HSP70 and AEEG in children with complex febrile convulsions and their correlation with secondary epilepsy

目的:探讨血清神经元特异性烯醇化(NSE)、热休克蛋白(HSP70)与动态脑电图(AEEG)在小儿复杂性热性惊厥(CFC)中的变化及其与继发癫痫的相关性。方法:按照惊厥类型不同将98例热性惊厥(FC)患儿分为单纯热性惊厥组(SFC组,n=44)和CFC组(n=54)。同时,50名疑似癫痫但结果正常的儿童作为对照组。对比各组血清NSE、HSP70与AEEG评分差异,采用Logistics回归分析影响CFC患儿继发癫痫的独立危险因素,以受试者工作特征(ROC)曲线研究血清NSE、HSP70与AEEG评分的诊断效能。结果:SFC组和CFC组的NSE、HSP70水平均高于对照组,AEEG评分低于对照组(P<0.05);CFC组的NSE、HSP70水平均高于SFC组,AEEG评分低于SFC组(P<0.05)。单因素分析显示,不同首次惊厥前发热时间、不同首次惊厥次数、不同围生期异常情况、不同血清NSE水平、不同HSP70水平与不同AEEG评分患儿继发癫痫率比较,差异有统计学意义(P<0.05)。多因素分析显示,首次惊厥次数及血清NSE、HSP70水平与AEEG评分是影响CFC患儿继发癫痫的独立危险因素(P<0.05)。各指标单独检测和联合检测的敏感度以联合检测最高。ROC曲线显示,联合检测AUC值最高。结论:血清NSE、HSP70在CFC患儿中明显升高,AEEG评分则明显下降;血清NSE、HSP70与AEEG评分的异常与CFC患儿继发癫痫显著相关,三者联合检测有助于评估癫痫的发生,为临床治疗提供科学依据。

Objective:To analyze the changes of serum neuron-specific enolation(NSE),heat shock protein(HSP70)and dynamic electroencephalography(AEEG)in children with complex febrile convulsion(CFC)and their correlation with secondary epilepsy.Methods:A total of 98 children with FC were selected as the research objects,including 44 children with SFC and 54 children with CFC,which were divided into SFC group and CFC group.At the same time,50 children with suspected epilepsy who received physical examination but normal results were selected as the control group.The differences of serum NSE,HSP70 and AEEG scores in each group were compared,and the independent risk factors affecting secondary epilepsy in children with CFC were analyzed by logistics regression analysis.ROC curve was used to evaluate the diagnostic efficacy of serum NSE,HSP70 and AEEG scores.Results:The levels of NSE and HSP70 in SFC and CFC groups were higher than those in control group,and the AEEG score was lower than that in control group(P<0.05).The levels of NSE and HSP70 in CFC group were higher than those in SFC group,and the AEEG score was lower than that in SFC group(P<0.05).Univariate analysis showed that different fever time before the first convulsion,different times of the first convulsion,different perinatal abnormalities,different serum NSE level,different HSP70 level and different AEEG score were different in the incidence of epilepsy(P<0.05).Multivariate analysis showed that the number of first convulsions,serum NSE and HSP70 levels and AEEG score were independent risk factors for secondary epilepsy in children with CFC(P<0.05).The sensitivity of single detection and combined detection was compared,the combined detection was the highest.ROC curve showed that the AUC of combined detection was the highest.Conclusion:Serum NSE and HSP70 are significantly increased in children with CFC,while AEEG is significantly decreased.Abnormal serum NSE,HSP70 and AEEG scores are significantly correlated with secondary epilepsy in children with CFC.Combined detection of the expressions of NSE,HSP70 and AEEG can help evaluate the occurrence of epilepsy and provide scientific basis for clinical treatment.