颞叶癫痫发作间期NLR、PLR和细胞因子的相关性分析

Correlative Analysis of NLR, PLR and Cytokines in Temporal Lobe Epilepsy during Interictal Period

目的 分析颞叶癫痫(temporal lobe epilepsy, TLE)患者发作间期外周血中性粒细胞/淋巴细胞(neutrophil/lymphocyte, NLR)、血小板/淋巴细胞(platelet/lymphocyte, PLR)及细胞因子水平的变化及其相关性,探讨炎症参与TLE发作的机制。方法 选取2020年10月~2022年7月于徐州医科大学附属医院神经内科就诊的172例TLE患者作为癫痫组,收集患者的临床资料。选取同院同期年龄、性别等基线资料与癫痫组匹配的健康体检者36例作为健康对照组。依据采血时距末次癫痫发作的时间将患者进行分组和数据收集。评估TLE患者发作间期NLR、PLR及细胞因子的变化并分析两者的相关性。结果 TLE发作后各项炎症指标均较健康人群显著升高。TLE 24h组NLR、PLR、白细胞介素-1β(interleukin-1β, IL-1β)、白细胞介素-6(interleukin-6, IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)水平均明显高于健康对照组(P<0.05);该期内IL-1β、IL-6、TNF-α与NLR、PLR呈正相关(均P<0.05)。TLE 72h组IL-1β、IL-6、TNF-α水平均明显高于健康对照组(P<0.05);该期内IL-1β、TNF-α与NLR呈正相关(均P<0.05)。TLE 1周组IL-1β、IL-6、TNF-α水平均明显高于健康对照组(P<0.05)。TLE 1个月组IL-1β水平明显高于健康对照组(P<0.05)。癫痫发作后,NLR、PLR呈下降后再回升趋势;NLR、PLR在TLE 1个月组最低。相反,IL-1β、IL-6、TNF-α水平在TLE 24h组最高,后呈持续下降趋势。结论 TLE患者发作间期炎性指标及细胞因子显著升高。发作后24h内炎症标志物及细胞因子间存在显著相关性,在TLE发作急性期发挥重要作用。

Objective To analyze the changes and correlation of neutrophil/lymphocyte(NLR),platelet/lymphocyte(PLR)and cytokine levels in peripheral blood of patients with temporal lobe epilepsy(TLE)during the interictal period and to investigate the mechanism of inflammation involved in TLE.Methods One hundred and seventy-two patients with TLE who treated in the Department of Neurology,the Affiliated Hospital of Xuzhou Medical University from October 2020 to July 2022 were selected as the epilepsy group,and the clinical data of the patients were collected.Thirty-six healthy physical examination subjects with age and gender and other baseline data matching the epilepsy group in the same period were selected as healthy control group.Patients were divided into groups according to the time from blood collection to the last seizure and data were collected.To evaluate the changes of NLR,PLR and cytokines in patients with TLE during interictal period and analyze the correlation between them.Results All inflammatory parameters were significantly increased after TLE attack compared with healthy people.The levels of NLR,PLR,interleukin-1β(IL-1β),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)in the TLE 24h group were significantly higher than those in the healthy control group(P<0.05),while IL-1β,IL-6 and TNF-αwere positively correlated with NLR and PLR(P<0.05).The levels of IL-1β,IL-6,and TNF-αin the TLE 72h group were significantly higher than those in the healthy control group(P<0.05),while IL-1βand TNF-αwere positively correlated with NLR(P<0.05).The levels of IL-1β,IL-6 and TNF-αwere significantly higher in the TLE 1-week group than those in the healthy control group(P<0.05).The level of IL-1βwas significantly higher in the TLE 1-month group than that in the healthy control group(P<0.05).NLR and PLR showed a decreasing trend after seizures and then increased;NLR and PLR had the lowest values in the TLE 1-month group.In contrast,the levels of IL-1β,IL-6 and TNF-αwere the highest in the TLE 24h group and then showed a continuous decreasing trend.Conclusion Inflammatory markers and cytokines were significantly increased in TLE patients during the interictal period.There is a significant correlation between inflammatory markers and cytokines within 24hours after onset and plays an important role in the acute phase of TLE onset.