血清胱抑素C、同型半胱氨酸与小儿热性惊厥及日后癫痫发作的关系

Relationship between serum cystatin C,homocysteine and febrile convulsion and later epileptic seizure in children

目的 探讨血清胱抑素C(Cys-C)、同型半胱氨酸(Hcy)与小儿热性惊厥(FC)及日后癫痫发作的关系。方法 选取2019年6月至2021年6月安顺市人民医院收治的125例FC患儿作为热性惊厥组,另外选取150例健康儿童作为对照组。采用酶联免疫吸附法检测患儿血清Cys-C、Hcy、C反应蛋白(CRP)、白介素-6(IL-6)、白介素-1β(IL-1β)水平。采用Pearson相关分析探讨血清Cys-C、Hcy与炎性因子指标的相关性,采用受试者操作特性(ROC)曲线评估血清Cys-C、Hcy对FC的预测价值,采用单因素及多因素Logistic回归分析探讨FC发展为癫痫的影响因素。结果 对照组儿童血清Cys-C、Hcy及炎性因子指标水平均低于热性惊厥组患儿(P<0.05)。热性惊厥患儿血清Cys-C、Hcy与CRP、IL-6、IL-1β均呈正相关(P<0.05)。血清Cys-C、Hcy预测FC的AUC(95%CI)分别为0.843(0.791~0.895)、0.871(0.819~0.923),两者联合预测的AUC(95%CI)为0.905(0.853~0.957)。随访1年11例FC患儿发展为癫痫(8.80%),癫痫组患儿血清Cys-C、Hcy水平高于无癫痫组患儿(P<0.05)。多因素Logistic回归分析显示,首次惊厥次数(OR=2.489)、癫痫家族史(OR=2.356)、Cys-C(OR=3.377)、Hcy(OR=2.815)是FC发展为癫痫的影响因素(P<0.05)。结论 血清Cys-C、Hcy水平在FC患儿中均升高,可作为预测FC发的生物学指标,且与FC患儿日后癫痫发作密切相关。

Objective To explore the relationship between serum cystatin C(Cys-C),homocysteine(Hcy)and febrile convulsion(FC)and future epileptic seizure in children.Methods A total of 125 children with FC admitted to People's Hospi-tal of Anshun City from June 2019 to June 2021 were selected as the febrile convulsion group,and 150 healthy children were selected as the control group.Serum levels of Cys-C,Hcy,C-reactive protein(CRP),interleukin-6(IL-6)and interleukin-1β(IL-1β)were detected by enzyme-linked immunosorbent assay.Pearson correlation analysis was used to investigate the corre-lation between serum Cys-C,Hcy and inflammatory factors.ROC curve was used to evaluate the predictive value of serum Cys-C and Hcy to FC.Univariate and multivariate Logistic regression analysis was used to investigate the influencing factors of FC development into epilepsy.Results The levels of serum Cys-C,Hcy and inflammatory factors in the control group were lower than those in the febrile convulsion group(P<0.05).Serum Cys-C and Hcy were positively correlated with CRP,IL-6 and IL-1βin children with febrile convulsion(P<0.05).The AUC(95%CI)of serum Cys-C and Hcy predicted FC were 0.843(0.791–0.895)and 0.871(0.819–0.923),respectively.The combined predicted AUC(95%CI)were 0.905(0.853–0.957).After 1 year of follow-up,11 of FC children developed epilepsy with a conversion rate of 8.80%.The levels of Cys-C and Hcy in the epileptic group were higher than those in the non-epileptic group(P<0.05).Multivariate Logistic regression showed that the number of first convulsions(OR=2.489),family history of epilepsy(OR=2.356),Cys-C(OR=3.377),Hcy(OR=2.815)were the influencing factors for the development of FC into epilepsy(P<0.05).Conclusion Serum Cys-C and Hcy levels were both increased in children with FC,which could be used as biological indicators to predict the occurrence of FC,and were closely related to future seizures in children with FC.