血清神经丝轻链蛋白水平与癫痫患者认知功能障碍的相关性

Correlation between serum neurofilament light chain protein levels and cognitive dysfunction in patients with epilepsy

目的探讨血清神经丝轻链蛋白(NFL)的水平与癫痫(EP)患者认知功能障碍的相关性,为预测癫痫患者发生认知功能障碍提供依据。方法纳入50例癫痫患者,其中癫痫认知障碍组25例,癫痫非认知障碍组25例;同期同年龄段健康对照者30例。比较癫痫认知障碍组与非认知障碍组及健康对照组血清中NFL水平;Pearson相关分析探究50例癫痫患者血清NFL水平与MoCA评分的相关性;绘制ROC曲线,计算曲线下面积(AUC),评估血清NFL水平预测癫痫患者发生认知功能障碍的价值;多因素Logistic回归分析癫痫患者发生认知功能障碍的影响因素。结果癫痫认知障碍组的血清NFL水平[0.345(0.272,0.418)]高于癫痫非认知障碍组[0.233(0.195,0.270)]和健康对照组[0.218(0.185,0.252)],差异有统计学意义(P<0.05);癫痫非认知障碍组的血清NFL水平高于对照组,差异无统计学意义(P>0.05)。癫痫患者血清NFL水平与MoCA评分呈负相关(r=—0.492,P<0.001),MoCA评分越低,血清NFL水平越高。血清NFL预测癫痫患者发生认知功能障碍的ROC曲线下面积AUC为0.7024,P值为0.014,差异有统计学意义(P<0.05)。服药种类数量、血清NFL水平是癫痫患者发生认知功能障碍的影响因素。结论血清NFL水平与癫痫患者认知功能成负相关,癫痫患者血清NFL水平越高,认知功能越差;血清NFL水平对癫痫患者发生认知功能障碍具有较高的预测价值;服药种类数量多、血清NFL水平高的癫痫患者发生认知功能障碍的风险较大。

Objective To explore the correlation between the level of serum Neurofilament light chain pro⁃tein(NFL)and cognitive dysfunction in epilepsy patients,which provides basis predicting cognitive dysfunction in epilepsy patients.Methods 50 patients with epilepsy were enrolled,including 25 patients with cognitive impair⁃ment and 25 patients without cognitive impairment in epilepsy group.30 age-matched healthy controls were recruited in the same period.The serum NFL levels were compared between the epilepsy group and the healthy control group,and the serum NFL levels were analyzed between the epilepsy cognitive dysfunction group and the non-cognitive dys⁃function group.Pearson correlation analysis was used to explore the correlation between serum NFL levels and MoCA scores in patients with epilepsy.The receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was calculated to evaluate the value of serum NFL level in predicting cognitive dysfunction in patients with epilepsy.Multivariate Logistic regression was used to analyze the influencing factors of cognitive impairment in patients with epilepsy.Results The level of serum NFL in the epilepsy cognitive impairment group[0.345(0.272,0.418)]was higher than that in the non-cognitive impairment group[0.233(0.195,0.270)]and the healthy control group[0.218(0.185,0.252)],and the difference was statistically significant(P<0.05).The level of serum NFL in the epilepsy without cognitive impairment group was higher than that in the control group,and the difference was not statis⁃tically significant(P>0.05).The serum NFL level was negatively correlated with MoCA score in patients with epilepsy(r=—0.492,P<0.001).The lower the MoCA score,the higher the serum NFL level.The area under the ROC curve of serum NFL for predicting cognitive impairment in patients with epilepsy was 0.7024,P value was 0.014,and the difference was statistically significant(P<0.05).The number of drugs and serum NFL level are the influencing factors of cognitive dysfunction in patients with epilepsy.Conclusion Serum NFL level is positively correlated with cognitive function in patients with epilepsy.The higher the serum NFL level,the worse the cognitive function in patients with epilepsy.Serum NFL level has a high predictive value for cognitive dysfunction in patients with epilepsy.Epilepsy patients with more types of medication and higher serum NFL level have a higher risk of cognitive dysfunction.