血清生长相关蛋白-43、α-突触核蛋白对小儿癫痫诊断价值研究

Study on the diagnostic value of serum growth related protein-43,α-synaptic nucleoprotein in pediatric epilepsy

目的探讨癫痫患儿血清生长相关蛋白-43(GAP-43)、α-突触核蛋白(α-Syn)水平,分析两者对小儿癫痫的诊断价值。方法纳入2019年4月—2022年4月临汾市人民医院儿科诊治小儿癫痫患者80例为癫痫组,晕厥患儿50例为晕厥组,腹股沟斜疝患儿50例为对照组。利用酶联免疫吸附试验检测血清GAP-43、α-Syn水平;比较3组患儿间及不同临床特征癫痫患儿血清GAP-43、α-Syn水平差异;Pearson相关分析血清GAP-43、α-Syn与癫痫发作严重程度量表评分(NHS3)的相关性;受试者工作特征曲线分析血清GAP-43、α-Syn对小儿癫痫的诊断价值。结果血清GAP-43水平比较,癫痫组<晕厥组<对照组(F/P=821.793/<0.001),血清α-Syn水平比较,癫痫组>晕厥组>对照组(F/P=419.176/<0.001);癫痫患儿血清GAP-43在癫痫局灶性发作、无认知功能损害者中升高(t/P=8.745/<0.001,10.070/<0.001),α-Syn水平在癫痫局灶性发作、无认知功能损害者中降低(t/P=4.236/<0.001,14.881/<0.001),二者在患儿性别、年龄、脑电图异常、头颅MR异常者中比较,差异无统计学意义(P均>0.05);血清GAP-43水平与NHS3评分呈显著负相关(r/P=-0.645/<0.001),血清α-Syn水平与NHS3评分呈显著正相关(r/P=0.702/<0.001);血清GAP-43、α-Syn及两项联合预测小儿癫痫的AUC分别为0.740、0.738、0.835,二项联合的AUC高于单项预测(Z=4.482、4.391,P均<0.001)。结论癫痫患儿血清GAP-43降低,α-Syn水平升高,两者与癫痫类型、认知功能损害有关,两项联合对小儿癫痫具有较高的诊断价值。

Objective To investigate the Serum Growth Associated Protein-43(GAP-43)in Children with Epilepsyα-Synaptic nuclear protein(α-Syn)level,analyze the diagnostic value of both for pediatric epilepsy.Methods Eighty pediatric epilepsy patients diagnosed and treated in the Pediatric Department of Linfen People's Hospital from April 2019 to April 2022 were included as the epilepsy group,50 children with syncope were included as the syncope group,and 50 children with inguinal hernia were included as the control group.Detection of serum GAP-43 using enzyme-linked immunosorbent assayα-Syn level.Compare the differences in serum GAP-43 levels among three groups of children with epilepsy and different clinical featuresα-Differences in Syn levels.Pearson correlation analysis of serum GAP-43α-The correlation between Syn and seizure severity scale score(NHS3).The diagnostic value of serum GAP-43,α-Syn and combination in pediatric epilepsy were analyzed by the receiver operating characteristic curve.Results Serum GAP-43 levels in epilepsy group<syncope group<control group,serumα-Syn level epilepsy group>syncope group>control group(F/P=821.793/<0.001,419.176/<0.001);The serum GAP-43 levels in children with epilepsy were elevated in patients with focal seizures and no cognitive impairment(t/P=8.745/<0.001,10.070/<0.001),α-Syn levels decreased in patients with focal seizures and no cognitive impairment(t/P=4.236/<0.001,14.881/<0.001),and there was no statistically significant difference between the two in terms of gender,age,abnormal electroencephalogram,and abnormal head MR(P>0.05);The serum GAP-43 level is significantly negatively correlated with NHS3 score(r/P=-0.645/<0.001),and the serumα-The level of Syn is significantly positively correlated with NHS3 score(r/P=0.702/<0.001);Serum GAP-43α-The AUC of Syn and two combined predictions for pediatric epilepsy were 0.740,0.738,and 0.835,respectively.The AUC of the two combined predictions was higher than that of the single prediction(Z=4.482 and 4.391,P<0.001).Conclusion The serum GAP-43 in children with epilepsy decreases,α-The elevated level of Syn is related to the type of epilepsy and cognitive impairment,and the combination of the two has high diagnostic value for pediatric epilepsy.