血清鸢尾素和热休克蛋白70水平与特发性癫痫患儿认知功能及发作控制的研究

Study on the relationship between serum irisin and heat shock protein 70 levels and cognitive function and seizure control in children with idiopathic epilepsy

目的 探讨血清鸢尾素、热休克蛋白70水平与特发性癫痫患儿认知功能及发作控制的关系。方法 选择2016年1月至2020年1月在本溪市中心医院儿科就诊的150例特发性癫痫患儿为研究对象。按照治疗后发作控制情况将其分作完全控制组(n=117例)和未完全控制组(n=33例),另选取同期健康体检儿童30例为对照组。检测并比较各组血清鸢尾素、热休克蛋白70水平的差异,并通过韦氏儿童智力量表第4版(WISC-Ⅳ)对患儿认知功能进行评估。采用Logistic回归法分析血清鸢尾素、热休克蛋白70水平与特发性癫痫患儿发作控制的关系。结果 未完全控制组血清鸢尾素水平均低于完全控制组和对照组,且完全控制组低于对照组,差异均有统计学意义(t值分别为20.296、21.872、9.426,P<0.05);而未完全控制组血清热休克蛋白70水平均高于完全控制组和对照组,且完全控制组高于对照组,差异均有统计学意义(t值分别为15.378、22.851、11.298,P<0.05)。完全控制组WISC-Ⅳ各维度评分均高于未完全控制组,差异有统计学意义(t=4.776~6.637,P<0.05)。Pearson相关性分析显示特发性癫痫患儿的血清鸢尾素水平与WISC-Ⅳ各维度评分均呈正相关(r=0.317~0.478,P<0.05),而热休克蛋白70水平与WISC-Ⅳ各维度评分均呈负相关(r=-0.567~-0.488,P<0.05)。多因素Logistic回归分析显示,血清鸢尾素水平降低、热休克蛋白70水平升高,以及发作类型为全面性、首次脑电图异常、有相关疾病家族史均是特发性癫痫患儿发作控制的显著影响因素(Waldχ^(2)值分别为10.328、14.651、6.255、7.204、8.495,P<0.05)。结论 特发性癫痫患儿认知功能损害及发作控制效果差与血清鸢尾素降低和热休克蛋白70水平升高密切相关。

Objective To study the relationship between the levels of serum irisin and heat shock protein 70 and cognitive function and seizure control in children with idiopathic epilepsy.Methods A total of 150 children with idiopathic epilepsy who were treated in the department of pediatrics of Benxi Central Hospital from January 2016 to January 2020 were selected as the research subjects.According to the seizure control after treatment, they were divided into the complete control group(n=117 cases) and the incomplete control group(n=33 cases),and 30 healthy children during the same period were selected as the control group.The differences in the levels of serum irisin and heat shock protein 70 in each group were detected and compared, and the cognitive function of the children was evaluated by the Wechsler Intelligence Scale for Children 4 th Edition(WISC-IV).Logistic regression was used to analyze the relationship between the levels of serum irisin and heat shock protein 70 and seizure control in children with idiopathic epilepsy.Results The serum irisin level in the incomplete control group was lower than that in the complete control group and the control group, and the irisin level in the complete control group was lower than that in the control group, and the differences were statistically significant(t values were 20.296,21.872 and 9.426,respectively, P<0.05).The level of serum heat shock protein 70 in the incomplete control group was higher than that in the complete control group and the control group, and the level of the heat shock protein 70 in the complete control group was higher than that in the control group, and the differences between groups were statistically significant(t values were 15.378,22.851 and 11.298,respectively, P<0.05).The Wechsler score of the complete control group was higher than that of the incomplete control group, the difference was statistically significant(t=4.776~6.637,P<0.05).Pearson correlation analysis showed that the level of serum irisin in children with idiopathic epilepsy was positively correlated with the scores of each dimension of WISC-IV(r=0.317~0.478,P<0.05),while heat shock protein 70 level was negatively correlated with the scores of each dimension of WISC-IV(r=-0.567~-0.488,P<0.05).Multivariate Logistic regression analysis showed that decreased irisin level, increased heat shock protein 70 level, comprehensive seizure type, first abnormal electroencephalography(EEG),and family history were all significant influencing factors for seizure control in children with idiopathic epilepsy(Waldχ^(2) values were 10.328,14.651,6.255,7.204 and 8.495,respectively, P<0.05).Conclusion Cognitive impairment and poor seizure control in children with idiopathic epilepsy are closely related to the decrease of serum irisin and the increase of heat shock protein 70.