卒中后癫痫患者的血清MBP、Nesfatin-1表达水平及其危险因素

Serum myelin basic protein and Nesfatin-1 expression levels and risk factors in patients with post-stroke epilepsy

目的观察卒中后癫痫患者的血清髓鞘碱性蛋白(MBP)、新饱食分子蛋白-1(Nesfatin-1)表达水平,并探讨其危险因素。方法回顾性分析2021年7月至2023年7月于肇庆市第一人民医院神经内科住院治疗的200例卒中患者临床资料,将卒中后发生癫痫的85例患者作为研究组,未发生癫痫的115例作为对照组。比较两组患者的年龄、性别、吸烟、饮酒、卒中部位、病灶范围、病灶大小、基础疾病、美国国立卫生院卒中量表(NIHSS)评分和血清MBP、Nesfatin-1水平,并采用Logistic回归分析影响卒中后癫痫的危险因素。结果两组患者的年龄、性别、吸烟、饮酒、基础疾病比较差异均无统计学意义(P>0.05);研究组患者卒中部位为皮质、病灶范围为多脑叶、病灶>5 cm2、NIHSS评分>20分的占比明显高于对照组,差异均有统计学意义(P<0.05);研究组患者的MBP、Nesfatin-1水平分别为(5129.17±211.18)pg/mL、(7.30±1.83)mg/mL,明显高于对照组的(3135.10±150.60)pg/mL、(3.66±0.78)mg/mL,差异均有统计学意义(P<0.05);Logistic回归分析结果显示,血清MBP、Nesfatin-1、卒中部位、病灶范围、病灶大小、NIHSS评分均是影响卒中后癫痫患者的危险因素(P<0.05)。结论血清MBP、Nesfatin-1、卒中部位、病灶范围、病灶大小、NIHSS评分均是影响卒中后癫痫患者的危险因素,需要对这些危险因素进行临床干预,以减少卒中后癫痫的发生率。

Objective To investigate and analyze the expression levels of serum myelin basic protein(MBP)and Nesfatin-1 and the risk factors in patients with post-stroke epilepsy.Methods The medical records of 200 stroke patients admitted to the Department of Neurology of the First People's Hospilal of Zhaoqing.from July 2021 to July 2023 were retrospectively analyzed.Among the patients,85 with epilepsy after stroke were selected as the study group,and 115 patients without epilepsy were selected as the control group.Serum MBP,Nesfatin-1,age,gender,smoking,alcohol consumption,stroke site,lesion scope,lesion size,underlying disease,and National Institutes of Health Stroke Scale(NIHSS)score were compared between the two groups.The risk factors affecting post-stroke epilepsy were analyzed by logistic regression.Results There was no statistically significant difference in age,gender,smoking,alcohol consumption,and underlying diseases between the two groups(P>0.05).The proportions of patients with stroke sites in the cortex,lesions in multiple lobes,lesion size>5 cm2,and NIHSS scores>20 points were significantly higher in the study group than in the control group(P<0.05).The levels of MBP and Nesfatin-1 in the study group were(5129.17±211.18)pg/mL and(7.30±1.83)mg/mL,which were significantly higher than(3135.10±150.60)pg/mL and(3.66±0.78)mg/mL in the control group(P<0.05).Logistic regression analysis showed that serum MBP,Nesfatin-1,stroke site,lesion scope,lesion size,and NIHSS score were all risk factors for patients with post-stroke epilepsy(P<0.05).Conclusion Serum MBP,Nesfatin-1,stroke site,lesion scope,lesion size,and NIHSS score are all risk factors affecting patients with post-stroke epilepsy.Clinical intervention of these risk factors is needed to reduce the incidence of post-stroke epilepsy.