脑梗死继发癫痫患者脑干听觉诱发电位与脑血流量相关性及意义

Correlation and significance of brainstem auditory evoked potentials and cerebral blood flow in patients with epilepsy secondary to cerebral infarction

目的 探究脑梗死继发癫痫患者脑干听觉诱发电位(brainstem auditory e-voked potential,BAEP)与脑血流量(cerebral blood flow,CBF)相关性及意义。方法 选取脑梗死继发癫痫患者80例作为研究组,另选同期脑梗死未继发癫痫患者80例作为对照组。比较2组入院时一般资料、CBF、血清脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)、神经元烯醇化酶(neuronal-specific enolase,NSE)水平及BAEP评分,分析脑梗死继发癫痫患者BAEP评分与CBF、血清Lp-PLA2、NSE水平的相关性,并比较研究组不同癫痫特征(发作类型、放电类型、放电部位)患者BAEP评分,分析BAEP评分与脑梗死继发癫痫发作特征的相关性,通过受试者工作特征(receiver operating characteristic,ROC)曲线分析BAEP评分、CBF、Lp-PLA2、NSE预测脑梗死继发癫痫的价值。结果 研究组CBF低于对照组,血清Lp-PLA2、NSE水平及BAEP评分均高于对照组(P<0.05);研究组BAEP评分与CBF呈负相关,与血清Lp-PLA2、NSE水平呈正相关(P<0.05);研究组癫痫全面发作患者BAEP评分高于部分发作患者,多灶性放电患者BAEP评分高于局灶性放电患者(P<0.05);BAEP评分与脑梗死继发癫痫发作类型、放电类型呈正相关(P<0.05);BAEP评分、CBF、Lp-PLA2、NSE预测脑梗死继发癫痫的曲线下面积(area under the curve,AUC)均>0.7,其中BAEP评分联合CBF、Lp-PLA2、NSE预测的AUC最大,为0.928(95%CI:0.876~0.963)。结论 脑梗死继发癫痫患者BAEP与CBF及血清Lp-PLA2、NSE水平密切相关,各指标联合在预测脑梗死继发癫痫方面具有较高预测效能。

Objective To investigate the correlation and significance of brainstem auditory evoked potentials(BAEP)and cerebral blood flow(CBF)in patients with epilepsy secondary to cerebral infarction.Methods A total of 80 patients with epilepsy secondary to cerebral infarction were selected as the research group,and another 80 patients without epilepsy secondary to cerebral infarction during the same period were selected as the control group.The general information,CBF,serum lipoprotein-associated phospholipase A2(Lp-PLA 2),neuron-specific enolase(NSE)levels and BAEP scores at admission were compared between two groups.The BAEP scores of patients with different epileptic characteristics(seizure type,discharge type,discharge site)in the research group were compared,and the correlation between BAEP scores and CBF,serum Lp-PLA2,and NSE levels in patients with epilepsy secondary to cerebral infarction was analyzed,and BAEP scores in patients with different characteristics of epilepsy secondary to cerebral infarction were compared.The correlation between BAEP score and the characteristics of epilepsy secondary to cerebral infarction was analyzed,and the value of BAEP scores,CBF,Lp-PLA2,and NSE in predicting epilepsy secondary to cerebral infarction was analyzed by receiver operating characteristic(ROC)curve.Results CBF was lower in the research group than in the control group,while serum Lp-PLA2 and NSE levels and BAEP scores were higher than those in the control group(P<0.05).BAEP scores were negatively correlated with CBF and positively correlated with serum Lp-PLA2 and NSE levels in the research group(P<0.05).BAEP scores were higher in patients with generalized seizures than in patients with partial seizures in the research group,and BAEP scores were higher in patients with multifocal discharge than in focal discharge patients(P<0.05).BAEP scores were positively correlated with seizure type and discharge type in patients with epilepsy secondary to cerebral infarction(P<0.05).The area under the curve(AUC)of BAEP scores,CBF,Lp-PLA2,and NSE in predicting epilepsy secondary to cerebral infarction was>0.7,in which BAEP scores combined with CBF,Lp PLA2,and NSE in prediction had the largest AUC of 0.928(95%CI:0.876-0.963).Conclusion BAEP in patients with epilepsy secondary to cerebral infarction is closely correlated with CBF and serum Lp-PLA2 and NSE levels,and the combination of the indicators has high predictive efficacy in predicting epilepsy secondary to cerebral infarction.