脑梗死后血清sIL-2R,Lp-PLA2水平变化对继发癫痫的预测作用

Predictive effect of serum SIL-2R and Lp-PLA2 levels on secondary epilepsy after cerebral infarction

目的分析可溶性白细胞介素-2受体(Soluble interleukin-2 receptor,sIL-2R)、脂蛋白相关磷脂酶A2(Lipoprotein associated phospholipaseA2,Lp-PLA2)水平变化对脑梗死后继发癫痫的预测作用。方法将58例2019年1月-2020年12月医院收治的脑梗死继发性癫痫患者设为观察组,另选取同期102例脑梗死未继发癫痫患者设为对照组,收集2组患者临床资料,并采用酶联免疫吸附法(Enzyme-linked immunosorbent assay,ELISA)检测2组患者血清中sIL-2R,Lp-PLA2水平,比较2组指标水平及其他可能影响脑梗死后继发癫痫的相关因素差异,Logistic回归分析明确危险因素,并以受试者工作特征曲线(Receiver operating characteristic curve,ROC)判断sIL-2R,Lp-PLA2水平对脑梗死患者继发癫痫的预测作用。结果观察组患者血清sIL-2R,Lp-PLA2水平、梗死灶部位包括脑叶占比、梗死灶直径≥2 cm占比高于对照组,且血氯值、血钠值低于对照组(P<0.05)。Logistic回归分析显示,sIL-2R,Lp-PLA2水平、血氯值、梗死灶部位包括脑叶、梗死灶直径≥2 cm、血钠值均是影响脑梗死患者继发癫痫的独立危险因素(P<0.05)。ROC分析显示,血清sIL-2R水平预测脑梗死患者继发癫痫的灵敏度为82.93%、特异度为72.37%、准确度为80.71%、曲线下面积(Areaunder the curve,AUC)为0.793;血清Lp-PLA2水平预测脑梗死患者继发癫痫的灵敏度为80.48%、特异度为74.91%、准确度为81.25%、AUC为0.768;二者联合预测脑梗死患者继发癫痫的灵敏度为93.66%、特异度为69.23%、准确度为88.50%、AUC为0.859。结论血清sIL-2R,Lp-PLA2水平异常升高与脑梗死患者继发癫痫有关,是导致脑梗死后继发癫痫的危险因素,二者联合检测对预测脑梗死后继发癫痫具有较高的临床价值。

Objective To analyze the predictive effect of soluble interleukin-2 receptor(sIL-2 R)and lipoprotein associated phospholipase A2(Lp-PLA2)on secondary epilepsy after cerebral infarction.Methods 58 patients with epilepsy secondary to cerebral infarction admitted to the hospital from January 2019 to December 2020 were selected as the observation group,and 102 patients without epilepsy after cerebral infarction were selected as the control group during the same period.The clinical data ofthe patientsfrom these two groups were collected.The serum sIL-2 R and Lp-PLA2 from these two groups were detected by enzyme-linked immunosorbent assay(ELISA).The values of these two factors and other related factors that may induce epilepsy secondary to cerebral infarction were compared between these two groups.The risk factors were determined by logistic regression analysis,and the predictive effect of sIL-2 R and Lp-PLA2 on secondary epilepsy in patients with cerebral infarction was calculated by the receiver operating characteristic(ROC)curve.Results The serum sIL-2 R and Lp-PLA2,the infarct location including proportion of brain lobes,and the proportion of infarct diameters≥2 cm in the observation group were higher than those in the control group(P<0.05).The values of serum chlorine and sodium in the observation group were lower than those in the control group(P<0.05).According to logistic regression analysis,it showed that serum sIL-2 R,chlorine,Lp-PLA2,infarct location including brain lobes,infarct diameters≥2 cm,and serum sodium are all independent risk factors inducing secondary epilepsy in patients with cerebral infarction(P<0.05).It showed that the sensitivity in predicting secondary epilepsy in patients with cerebral infarction by serum sIL-2 R was 82.93%,specificity was 72.37%,accuracy was 80.71%,and area under the curve(AUC)was 0.793 by ROC analysis;while the sensitivity in predicting secondary epilepsy by serum Lp-PLA2 was 80.48%,the specificity was 74.91%,the accuracy was 81.25%,and the AUC was 0.768.The sensitivity in predicting secondary epilepsy in patients with cerebral infarction by serum sIL-2 R combined to Lp-PLA2 was 93.66%,the specificity was 69.23%,the accuracy was 88.50%,and AUC was 0.859.Conclusion Extremely increased levels of serum sIL-2 R and Lp-PLA2 are associated with secondary epilepsy in patients with cerebral infarction.They are risk factors inducing secondary epilepsy after cerebral infarction.It is valuable in clinic by combined these two factors to predict secondary epilepsy after cerebral infarction.