癫痫患者血清NFL、Hcy、Irisin与认知功能和治疗后发作控制的关系

Relationship between Serum NFL,Hcy,Irisin and Cognitive Function and Seizure Control after Treatment in Patients with Epilepsy

目的:探讨癫痫患者血清神经丝轻链蛋白(NFL)、同型半胱氨酸(Hcy)、鸢尾素(Irisin)与认知功能和治疗后发作控制的关系。方法:选择2021年2月至2023年2月徐州医科大学附属医院收治的196例癫痫患者,根据蒙特利尔认知评估量表(MoCA)评估结果,将患者分为认知障碍组和非认知障碍组,各为70例和126例。所有癫痫患者接受抗癫痫药物治疗,治疗前检测血清NFL、Hcy、Irisin水平,治疗后6个月评价发作控制情况,并据此将患者分为完全控制组(139例)和未完全控制组(57例)。多因素Logistic回归分析影响癫痫患者治疗后发作未完全控制的因素。结果:认知障碍组Irisin水平低于非认知障碍组,血清NFL、Hcy水平高于非认知障碍组(P<0.05)。未完全控制组血清NFL、Hcy水平高于未完全控制组(P<0.05),Irisin水平低于未完全控制组(P<0.05)。脑电图异常、全面性发作、高NFL、Hcy是癫痫患者抗癫痫治疗后未完全控制的危险因素(P<0.05),高Irisin是保护因素(P<0.05)。结论:癫痫伴认知障碍患者血清NFL、Hcy水平升高,Irisin水平降低,且与抗癫痫治疗后发作控制情况有关。

Objective:To investigate the relationship between serum neurofilament light chain protein(NFL),homocysteine(Hcy),irisin(Irisin)and cognitive function and seizure control after treatment in patients with epilepsy.Methods:196 patients with epilepsy admitted to The Affiliated Hospital of Xuzhou Medical University from February 2021 to February 2023 were selected,according to the evaluation results of the Montreal Cognitive Assessment Scale(MoCA),patients were divided into cognitive impairment group and non-cognitive impairment group,with 70 cases and 126 cases respectively.All patients with epilepsy were treated with antiepileptic drugs,the levels of serum NFL,Hcy and Irisin were detected before treatment,the seizure control was evaluated 6 months after treatment,the patients were divided into complete control group(139 cases)and incomplete control group(57cases)according to this.The factors affecting the incomplete control of seizures in patients with epilepsy after treatment were analyzed by multivariate Logistic regression analysis.Results:The level of Irisin in cognitive impairment group was lower than that in non-cognitive impairment group,and the levels of serum NFL and Hcy were higher than those in non-cognitive impairment group(P<0.05).The levels of serum NFL and Hcy in incomplete control group were higher than those in incomplete control group(P<0.05),and the level of Irisin was lower than that in incomplete control group(P<0.05).Electroencephalogram abnormalities,generalized seizures,high NFL and Hcy were risk factors for incomplete control after antiepileptic treatment in patients with epilepsy(P<0.05),and high Irisin was a protective factor(P<0.05).Conclusion:The levels of serum NFL and Hcy in patients with epilepsy and cognitive impairment are increase,and the level of Irisin is decrease,which are relate to the control of seizures after antiepileptic treatment.