[1]郭　娜a,马　英a,王琳莹a,等.脑卒中患者血清 Hcy及 NSE水平与癫痫发作的相关性研究[J].现代检验医学杂志,2022,37(01):177-181.[doi:10.3969/j.issn.1671-7414.2022.01.036]
　GUO Naa,MA Yinga,WANG Lin-yinga,et al.Correlation between Serum Hcy, NSE Levels and Epileptic Seizures in Patients with Stroke[J].Journal of Modern Laboratory Medicine,2022,37(01):177-181.[doi:10.3969/j.issn.1671-7414.2022.01.036]
点击复制

脑卒中患者血清 Hcy及 NSE水平与癫痫发作的相关性研究()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年01期
页码:
177-181
栏目:
检验与临床
出版日期:
2022-01-15

文章信息/Info

Title:
Correlation between Serum Hcy, NSE Levels and Epileptic Seizures in Patients with Stroke
文章编号:
1671-7414（2022）01-177-05
作者:
郭　娜a; 马　英a; 王琳莹a; 周利娜b; 刘盛佳c
（保定第四中心医院a. 神经内科;b. 门诊西药房;c. 病案室, 河北保定 072350)
Author(s):
GUO Naa;  MA Yinga;  WANG Lin-yinga;  ZHOU Li-nab;  LIU Sheng-jiac
（a.Department of Neurology;b.Outpatient Pharmacy; c.Medical Records Room,the Fourth Central Hospital ofBaoding City, Hebei Baoding 072350, China）
关键词:
同型半胱氨酸（Hcy）; 神经元特异性烯醇化酶（NSE）; 脑卒中; 癫痫
分类号:
R743.33；R446.112
DOI:
10.3969/j.issn.1671-7414.2022.01.036
文献标志码:
A
摘要:
目的　探讨脑卒中患者血清同型半胱氨酸 (homocysteine, Hcy)及神经元特异性烯醇化酶 (neuron speci.c enolase, NSE)对其癫痫发作的影响。方法　研究对象为 2016年 1月～ 2019年 6月期间到保定市第四中心医院就诊的脑卒中患者，其中并发癫痫患者 160例，纳入癫痫组，随机抽取同期未并发癫痫患者 160例，纳入对照组。采用 ELISA(酶联免疫吸附试验 )法检测所有患者血清中 Hcy和 NSE的表达水平。采用单因素考察癫痫发作影响因素；采用 Pearson相关分析 Hcy和 NSE与癫痫患者卒中评分的关系；选取单因素中具有统计学差异的关键因素进行多因素 logistic回归；绘制癫痫发作的 ROC曲线，并计算曲线下面积 (AUC)。结果　癫痫组和对照组的年龄 ( ≥ 80岁 )、卒中类型 (梗死 /出血 )、脑血管疾病家族史、高脂血症、同型半胱氨酸尿症、肺部感染、 NIHSS评分 ( ≥ 25分 )，BI评分≥ 55分 )及病灶范围 9个参数差异均有统计学意义 (χ2 =5.472~18.315，均 P<0.01)；癫痫组的血清 Hcy为 51.34±7.48μmol/L，高于对照组的31.85±5.04μmol/L，经 t检验具有显著差别（ t=27.333，P<0.001）；癫痫组的血清 NSE为 62.47±8.11ng/ml，高于对照组的 35.40±5.43ng/ml，经 t检验，差异有统计学意义（t=35.083，P<0.001）。Pearson相关分析显示，血清 Hcy水平 (r=0.314， P<0.001)，NSE(r=0.352，P<0.001)与脑卒中 NIHSS评分呈正相关，而血清 Hcy水平 (r= -0.338，P<0.001)，NSE(r =-0.257， P<0.001)与 BI评分呈负相关。 Logistic回归分析可知， NIHSS评分 ( ≥ 25分 )(OR=3.781，95%CI 1.441~9.919)，BI评分 (<55分 )(OR=3.546，95%CI 1.220~10.305)、大的病灶范围 (OR=2.996，95%CI 1.137~7.738)、血清 Hcy(OR=4.014， 95%CI 1.590~10.134)及血清 NSE(OR=4.325，95%CI 1.776~10.530)是影响脑卒中患者癫痫发作的独立危险因素。 ROC曲线分析结果显示：血清 Hcy的 ROC曲线下面积为 0.820，敏感度和特异度分别为 79.2%和 70.3%，血清 NSE的 ROC曲线下面积为 0.873，预测的敏感度和特异度分别为 83.7%和 84.0%。结论　脑卒中患者血清 Hcy和 NSE与其癫痫发作的关系密切，可作为预测其发作的潜在标志物。
Abstract:
Objective　To investigate the effect of serum homocysteine (Hcy) and neuron specific enolase (NSE) on epilepticseizures in stroke patients. Methods　The subjects were stroke patients from January 2016 to June 2019 in the Fourth CentralHospital of Baoding City. Among them, 160 patients with epilepsy were included in the epilepsy group, 160 patients withoutepilepsy were randomly selected as the control group. Enzyme linked immunosorbent assay(ELISA) was used to detect theexpression of Hcy and NSE in serum of all patients. Single factor was used to investigate the influencing factors of epilepsyattack. Pearson correlation was used to analyze the relationship between Hcy, NSE and stroke score of patients with epilepsy. Thekey factors with statistical difference in single factor were selected for multivariate logistic regression and the ROC curve ofepilepsy attack was drawn and the area under curve (AUC) was calculated. Results　There were significant differences in age( ≥ 80 years old), stroke type (infarction/ hemorrhage), family history of cerebrovascular disease, hyperlipidemia,hyperhomocysteinemia, pulmonary infection, NIHSS score ( ≥ 25), BI score ( ≥ 55) and lesion size between the epilepsy groupand control groups (χ2 =5.472~18.315, all P<0.01). The serum Hcy of epilepsy group was 51.34±7.48μmol/L, which was higherthan that of the control group 31.85±5.04μmol/L, there was significant difference between the two groups (t= 27.333,P < 0.001). The serum NSE level in epilepsy group was 62.47±8.11 ng/ml, higher than 35.40±5.43 ng/ml, with significantdifference by t test (t= 35.083, P< 0. 001). Pearson correlation analysis showed that serum Hcy level (r = 0.314, P<0.001) andNSE (r = 0.352, P<0.001) were positively correlated with NIHSS score of stroke, while serum Hcy level (r = -0.338, P<0.001)and NSE (r = -0.257, P <0.001) were negatively correlated with BI score. Logistic regression analysis showed that NIHSS score( ≥ 25score) (OR= 3.781, 95% CI 1.441~9.919), BI score (<55 score) (OR= 3.546, 95% CI 1.220~10.305), large lesion range(OR = 2.996, 95% CI 1.137~7.738), serum Hcy (OR = 4.014, 95% CI 1.590~10.134), serum NSE (OR= 4.325, 95% CI1.590~10.134) was an independent risk factor for epilepsy in stroke patients. ROC curve analysis showed that the area under theROC curve of serum Hcy was 0.820. The sensitivity and the specificity were 79.2% and 70.3% respectively, and the area underthe ROC curve of serum NSE was 0.873, and the sensitivity and the specificity of prediction were 83.7% and 84.0% respectively.Conclusion　Serum Hcy and NSE in stroke patients were closely related to their seizures, which can be used as potentialmarkers to predict their seizures.

参考文献/References:

[1] BURNEO J G, ANTAYA T C, ALLEN B N, et al. Therisk of new-onset epilepsy and refractory epilepsy inolder adult stroke survivors[J]. Neurology, 2019, 93(6):e568-e577.
[2] ABRAIRA L, TOLEDO M, GUZM?N L, et al. Longtermepilepsy after early post-stroke status epilepticus[J]. Seizure, 2019, 69: 193-197.
[3] BNOUHANNA W, SATT? A, MOUNACH J, et al.Overview of post-stroke epilepsy[J]. Open AccessLibrary Journal, 2019, 6(8): 1-10.
[4] 许冬美. 脑卒中患者癫痫发作的危险因素及脑电图表现[J]. 医学临床研究, 2019, 36(2):247-249,253.XU Dongmei. Multi factor analysis and electroencephalogram of epileptic seizures in strok epatients [J].Journal of Clinical Research, 2019, 36(2):247-249,253.
[5] XU M Y. Poststroke seizure: optimising itsmanagement[J]. Stroke and Vascular Neurology, 2018,4(1): 48-56.
[6] 刘少平, 韩利蓉, 余卉, 等. 急性脑梗死血清 Hcy，hs-CRP 及NSE 的水平变化[J]. 心脑血管病防治,2016, 16(2):127-128,142.LIU Shaoping, HAN Lirong, YU Hui,et al. Changesof serum Hcy, hs-CRP and NSE in patients with acutecerebral infarction[J]. Prevention and Treatment of Cardio-Cerebral-Vascular Disease, 2016, 16(2):127-128,142.
[7] 蓝永乐, 李介华, 温雪仪, 等. 血清Hcy 和NSE 水平与首发精神分裂症患者认知功能的相关性分析[J]. 检验医学与临床, 2018, 15(18): 2791-2794.LAN Yongle, LI Jiehua, WEN Xueyi, et al. Correlationbetween serum Hcy and NSE levels and cognitive functionin first-episode schizophrenic patients[J]. LaboratoryMedicine and Clinic, 2018, 15(18): 2791-2794.
[8] 中华医学会神经病学分会. 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志, 2018,51(9):666-682.Chinese Society of Neurology, Chinese StrokeSociety， Chinese Medical Association. Chineseguidelines for diagnosis and treatment of acuteischemic stroke 2018 [J]. Chinese Journal of Neurology,2018,51(9):666-682.
[9] HASAN T F, RABINSTEIN A A, MIDDLEBROOKSE H, et al. Diagnosis and management of acute ischemicstroke[J]. Mayo Clinic Proceedings, 2018, 93(4): 523-538.
[10] FEYISSA A M, HASAN T F, MESCHIA J F. Strokerelatedepilepsy[J]. European Journal of Neurology,2019, 26(1): 18- e3.
[11] 刘彬. 脑卒中后癫痫相关因素研究[J]. 中国城乡企业卫生, 2018, 33(3):92-93.LIU Bin. Study on related factors of epilepsy afterstroke[J]. Chinese Journal of Urban and RuralEnterprise Hygiene, 2018, 33(3):92-93.
[12] ZHAO Yinghao, LI Xiangyan, ZHANG Kun, et al.The progress of epilepsy after stroke[J]. CurrentNeuropharmacology, 2018, 16(1): 71-78.
[13] 范艳平, 易甲其, 吴敏. 缺血性脑卒中患者血清Hcy和EPO 水平的变化及其与颈动脉粥样硬化关系[J].现代检验医学杂志,2017,32(1):80-83.FAN Yanping,YI Jiaqi, WU Min. Changes of serumHcy and EPO levels in patients with ischemicstroke and their relationship with carotid arteryatherosclerosis [J]. Journal of Modern LaboratoryMedicine,2017,32(1):80-83.
[14] 洪震, 王丽轩, 张丽冉, 等. 老年脑梗死后病人继发脑出血与血清同型半胱氨酸及肿瘤坏死因子水平相关性分析[J]. 实用老年医学, 2020,34(6):554-557.HONG Zhen,WANG Lixuan,ZHANG Liran,et al. Correlationof homocysteine and TNF-α with hemorrhagictransformation in the elderly patients with cerebralinfarction [J]. Practical Geriatrics, 2020,34(6):554-557.
[15] 荆炳霞, 马云宝.Hcy 的基础及临床研究进展[J]. 放射免疫学杂志, 2008, 21(2):163-166.JING Bingxia, MA Yunbao. Basic and clinical researchprogress of Hcy[J]. Journal of Radioimmunology, 2008,21(2):163-166.
[16] 李雅静, 张瑞, 吴欣, 等.H 型高血压并发缺血性脑卒中患者MTHFR C677T 基因多态性及血清Hcy 水平的相关性研究[J].现代检验医学杂志, 2019, 34 (2):9-13.LI Yajing, ZHANG Rui, WU Xin, et al. Relationshipbetween MTHFR C677T gene polymorphisms andserum Hcy level in H type hypertension with ischemicstroke [J]. Journal of Modern Laboratory Medicine,2019, 34(2):9-13.
[17] 李亚琴, 罗仁国. 血清NSE, Hcy 及H-FABP 检测在急性脑梗死诊断中的应用价值[J]. 脑与神经疾病杂志, 2019, 27(4): 238-241.LI Yaqin, LUO Renguo. Application value of serumNSE, Hcy, H-FABP in diagnosis of acute cerebralinfarction [J]. Journal of Brain and Nervous Diseases,2019, 27(4): 238-241.
[18] 张晓阳，范振增．神经元特异性烯醇化酶NSE 的应用及研究进展[J]. 中国医药导报,2015,12(12):40-44.ZHANG Xiaoyang,FAN Zhenzeng. Application andresearch progress of neuron specific enolase [J] ChinaMedical Herald, ,2015,12(12):40-44．
[19] 胡杨真，黄婉洁，刘双凤．同型半胱氨酸、神经元特异性烯醇化酶与脑卒中的关系[J]．深圳中西医结合杂志, 2019, 29(8):4-6.HU Yangzhen, HUANG Wanjie, LIU Shuangfeng.Relationship between homocysteine, neuron specificenolase and stroke[J]. Shenzhen Journal of IntegratedTraditional Chinese and Western Medicine, 2019,29(8):4-6.

备注/Memo

备注/Memo:
基金项目：保定市社发类项目《卒中后癫痫的危险因素相关性及治疗研究》（编号：2041ZF034）。
作者简介：郭娜(1981-)，女，本科，主治医师，研究方向：癫痫、脑出血、脑血管病，E-mail:zhuzhu809@126.com。
更新日期/Last Update: 1900-01-01