血清ZAG、TLR4及CyPA在癫痫患者中的检测意义及其与癫痫认知功能异常的相关性分析

Significance of serum ZAG, TLR4 and CyPA in epilepsy patients and its correlation with abnormal cognitive function in epilepsy

目的探讨血清锌α2糖蛋白(ZAG)、Toll样受体4(TLR4)及亲环素A(CyPA)在癫痫患者中的检测意义及其与癫痫认知功能异常的相关性。方法回顾性选取2020年10月至2023年10月唐山市人民医院收治的83例癫痫患者作为观察组,根据患者蒙特利尔认知功能评估量表(MoCA)评测结果,将其分为认知功能异常组(n=53)与认知功能正常组(n=30)2个亚组,另选取同期在本院体检的83名健康志愿者作为对照组。比较观察组与对照组血清ZAG、TLR4及CyPA表达水平,采用受试者操作特征(ROC)曲线明确血清ZAG、TLR4及CyPA对癫痫的诊断价值。进一步对比认知功能异常组与认知功能正常组血清ZAG、TLR4及CyPA表达水平的差异,采用Pearson相关性分析对ZAG、TLR4及CyPA与癫痫患者认知功能的相关性进行分析。结果观察组ZAG水平为(34.24±4.26)μg/mL,低于对照组[(48.33±7.21)μg/mL],观察组TLR4、CyPA水平分别为(4.57±1.25)、(5.76±1.35)ng/L,均高于对照组[(1.01±0.23)、(2.15±0.34)ng/L],差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,CyPA、TLR4、ZAG对癫痫的诊断曲线下面积(AUC)分别为0.698、0.721、0.641,3者联合对癫痫的诊断AUC为0.897,AUC明显高于单一指标(P<0.05)。认知功能异常组ZAG水平为(31.45±5.26)μg/mL,低于认知功能正常组[(40.36±5.64)μg/mL],认知功能异常组TLR4、CyPA水平分别为(6.56±1.66)、(7.15±2.47)ng/L,均高于认知功能正常组[(3.64±0.67)、(4.57±1.68)ng/L],差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,ZAG与癫痫患者MoCA评分呈负相关(r=-0.521,P<0.05),TLR4、CyPA与癫痫患者认知功能呈正相关(r=0.483、0.597,P<0.05)。结论血清ZAG、TLR4及CyPA 3者联合对癫痫的诊断及预测具有重要价值,且其与癫痫患者认知功能具有密切关系。

Objective To investigate the significance of serum zinc alpha 2 glycoprotein(ZAG),Toll-like receptor 4(TLR4)and cyclophilin A(CyPA)detection in patients with epilepsy and their correlation with cognitive abnormalities in epilepsy.Methods Eighty-three epilepsy patients admitted to Tangshan People's Hospital from October 2020 to October 2023 were retrospectively selected as the observation group,and the patients were divided into 2 subgroups,the cognitive function abnormal group(n=53)and the cognitive function normal group(n=30)according to the results of montreal cognitive assessment scale(MoCA),and 83 healthy volunteers for physical examination in our hospital during the same period were also selected as the control group.The serum ZAG,TLR4 and CyPA expression levels were compared between the observation group and the control group,and the diagnostic value of serum ZAG,TLR4 and CyPA for epilepsy was clarified by using receiver operating characteristic(ROC)curve.The differences in the expression levels of serum ZAG,TLR4 and CyPA between the cognitive function abnormal group and the cognitive function normal group were further compared,The Pearson correlation analysis was used to analyze the correlation between ZAG,TLR4 and CyPA and cognitive function of epileptic patients.Results The level of ZAG in the observation group was(34.24±4.26)μg/mL,which was lower than that in the control group[(48.33±7.21)μg/mL],the levels of TLR4,CyPA in the observation group were(4.57±1.25),(5.76±1.35)ng/L,respectively,which were higher than those in the control group[(1.01±0.23),(2.15±0.34)ng/L],and the differences were statistically significant(P<0.05).The result of ROC curve showed that,the area under the curve(AUC)of CyPA,TLR4,and ZAG for epilepsy was 0.698,0.721,and 0.641,respectively.The combined area under the diagnostic curve of CyPA,TLR4,and ZAG for epilepsy was 0.897,which was significantly higher than that of a single indicator(P<0.05).The ZAG level in the cognitive function abnormal group was(31.45±5.26)μg/mL,which was lower than that in the cognitive function normal group[(40.36±5.64)μg/mL],and the levels of TLR4,CyPA in the cognitive function abnormal group were(6.56±1.66),(7.15±2.47)ng/L,respectively,which were higher than thsoe in the cognitive function normal group[(3.64±0.67),(4.57±1.68)ng/L],and the differences were statistically significant(P<0.05).The result of Pearson correlation analysis showed that,ZAG was negatively correlated with MoCA scores in epilepsy patients(r=-0.521,P<0.05),and TLR4 and CyPA were positively correlated with cognitive function in epilepsy patients(r=0.483,0.597,P<0.05).Conclusion The combination of serum ZAG,TLR4 and CyPA3 is valuable for the diagnosis and prediction of epilepsy,and it has a close relationship with cognitive function in patients with epilepsy.