[1]慕鹏莺,王梦碧,刘晓荷,等.脑梗死后血清sIL-2R,Lp-PLA2水平变化对继发癫痫的预测作用[J].卒中与神经疾病杂志,2022,29(04):344-348.[doi:10.3969/j.issn.1007-0478.2022.04.008]
　Mu Pengying,Wang Mengbi,Liu Xiaohe,et al.Predictive effect of serum SIL-2R and Lp-PLA2 levels on secondary epilepsy after cerebral infarction[J].Stroke and Nervous Diseases,2022,29(04):344-348.[doi:10.3969/j.issn.1007-0478.2022.04.008]
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脑梗死后血清sIL-2R,Lp-PLA2水平变化对继发癫痫的预测作用()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第29卷
期数:
2022年04期
页码:
344-348
栏目:
论著
出版日期:
2022-09-10

文章信息/Info

Title:
Predictive effect of serum SIL-2R and Lp-PLA2 levels on secondary epilepsy after cerebral infarction
文章编号:
1007-0478(2022)04-0344-05
作者:
慕鹏莺; 王梦碧; 刘晓荷; 马少玲; 宋海英
719000 陕西省榆林市星元医院神经内三科(慕鹏莺 王梦碧 刘晓荷 马少玲),神经内一科[宋海英(通信作者)]
Author(s):
Mu Pengying;  Wang Mengbi;  Liu Xiaohe;  et al.
The Third Department of Neurology,Xingyuan Hospital, Yulin Shanxi 719000
关键词:
脑梗死; 癫痫; 白细胞介素-2受体; 脂蛋白相关磷脂酶A2; 预测作用
Keywords:
Cerebral infarction Epilepsy Interleukin-2 receptor Lipoprotein associated phospholipase A2 Predictive effect
分类号:
R743
DOI:
10.3969/j.issn.1007-0478.2022.04.008
文献标志码:
A
摘要:
目的 分析可溶性白细胞介素-2受体(Soluble interleukin-2 receptor,sIL-2R)、脂蛋白相关磷脂酶A2(Lipoprotein associated phospholipaseA2,Lp-PLA2)水平变化对脑梗死后继发癫痫的预测作用。方法 将58例2019年1月-2020年12月医院收治的脑梗死继发性癫痫患者设为观察组,另选取同期102例脑梗死未继发癫痫患者设为对照组,收集2组患者临床资料,并采用酶联免疫吸附法(Enzyme-linked immunosorbent assay,ELISA)检测2组患者血清中sIL-2R,Lp-PLA2水平,比较2组指标水平及其他可能影响脑梗死后继发癫痫的相关因素差异,Logistic回归分析明确危险因素,并以受试者工作特征曲线(Receiver operating characteristic curve,ROC)判断sIL-2R,Lp-PLA2水平对脑梗死患者继发癫痫的预测作用。结果 观察组患者血清sIL-2R,Lp-PLA2水平、梗死灶部位包括脑叶占比、梗死灶直径≥2 cm占比高于对照组,且血氯值、血钠值低于对照组(P<0.05)。Logistic回归分析显示,sIL-2R,Lp-PLA2水平、血氯值、梗死灶部位包括脑叶、梗死灶直径≥2 cm、血钠值均是影响脑梗死患者继发癫痫的独立危险因素(P<0.05)。ROC分析显示,血清sIL-2R水平预测脑梗死患者继发癫痫的灵敏度为82.93%、特异度为72.37%、准确度为80.71%、曲线下面积(Areaunder the curve,AUC)为0.793; 血清Lp-PLA2水平预测脑梗死患者继发癫痫的灵敏度为80.48%、特异度为74.91%、准确度为81.25%、AUC为0.768; 二者联合预测脑梗死患者继发癫痫的灵敏度为93.66%、特异度为69.23%、准确度为88.50%、AUC为0.859。结论 血清sIL-2R,Lp-PLA2水平异常升高与脑梗死患者继发癫痫有关,是导致脑梗死后继发癫痫的危险因素,二者联合检测对预测脑梗死后继发癫痫具有较高的临床价值。
Abstract:
ObjectiveTo analyze the predictive effect of soluble interleukin-2 receptor(sIL-2R)and lipoprotein associated phospholipase A2(Lp-PLA2)on secondary epilepsy after cerebral infarction.Methods 58 patients with epilepsy secondary to cerebral infarction admitted to the hospital from January 2019 to December 2020 were selected as the observation group, and 102 patients without epilepsy after cerebral infarction were selected as the control group during the same period. The clinical data ofthe patientsfrom these two groups were collected. The serum sIL-2R and Lp-PLA2 from these two groups were detected by enzyme-linked immunosorbent assay(ELISA). The values of these two factors and other related factors that may induce epilepsy secondary to cerebral infarction were compared between these two groups. The risk factors were determined by logistic regression analysis, and the predictive effect of sIL-2R and Lp-PLA2 on secondary epilepsy in patients with cerebral infarction was calculated by the receiver operating characteristic(ROC)curve.Results The serum sIL-2R and Lp-PLA2, the infarct location including proportion of brain lobes, and the proportion of infarct diameters ≥ 2 cm in the observation group were higher than those in the control group(P<0.05).The values of serum chlorine and sodium in the observation group were lower than those in the control group(P<0.05). According to logistic regression analysis, it showed that serum sIL-2R, chlorine, Lp-PLA2, infarct location including brain lobes, infarct diameters ≥2 cm, and serum sodium are all independent risk factors inducing secondary epilepsy in patients with cerebral infarction(P<0.05). It showed that the sensitivity in predicting secondary epilepsy in patients with cerebral infarction by serum sIL-2R was 82.93%, specificity was 72.37%, accuracy was 80.71%, and area under the curve(AUC)was 0.793 by ROC analysis; while the sensitivity in predicting secondary epilepsy by serum Lp-PLA2 was 80.48%,the specificity was 74.91%, the accuracy was 81.25%, and the AUC was 0.768.The sensitivity in predicting secondary epilepsy in patients with cerebral infarction by serum sIL-2R combined to Lp-PLA2 was 93.66%, the specificity was 69.23%, the accuracy was 88.50%, and AUC was 0.859.Conclusion Extremely increased levels of serum sIL-2R and Lp-PLA2 are associated with secondary epilepsy in patients with cerebral infarction. They are risk factors inducing secondary epilepsy after cerebral infarction. It is valuable in clinic by combined these two factors to predict secondary epilepsy after cerebral infarction.

参考文献/References:

[1] 刘宵,王琳,任浩,等.血清胱抑素C对急性脑梗死预后的预测价值[J].河北医科大学学报,2018,39(4):387-390, 395.
[2] Gao C, Li Z, Bai J, et al. Involvement of monocarboxylate transporters in the cross-tolerance between epilepsy and cerebral infarction: A promising choice towards new treatments[J]. Neurosci Lett, 2019, 707(7): 134305.
[3] 付萌萌,汪银洲,李永坤,等.缺血性卒中患者首次癫痫发作后复发的危险因素分析[J].中国脑血管病杂志,2018,15(8):398-403.
[4] Hiragi T, Ikegaya Y, Koyama R. Microglia after Seizures and in Epilepsy[J]. Cells, 2018, 7(4): 26.
[5] Van WA, Smidt LC, Seute T, et al. Diagnostic markers for CNS lymphoma in blood and cerebrospinal fluid: a systematic review[J]. Br J Haematol, 2018, 182(3): 384-403.
[6] Kocak S, Ertekin B, Girisgin AS, et al. Lipoprotein-associated phospholipase-A(2)activity and its diagnostic potential in patients with acute coronary syndrome and acute ischemic stroke[J]. Turk J Emerg Med, 2017, 17(2): 56-60.
[7] 赖苹,何彦玲,杨超.急性脑梗死患者颈动脉粥样硬化及血流动力学参数变化[J].海南医学,2018,29(5):669-671.
[8] Song LL, Wang YM, Wu XX, et al. Correlation between AT1R gene polymorphism and epilepsy secondary to cerebral infarction[J]. Eur Rev Med Pharmacol Sci, 2020, 24(12): 6873-6880.
[9] Löscher W, Potschka H, Sisodiya SM, et al. Drug resistance in epilepsy: clinical impact, potential mechanisms, and new innovative treatment options[J]. Pharmacol Rev, 2020, 72(3): 606-638.
[10] 潘瑜,孙毅,潘柳青.高龄癫痫患者脑电图检查及炎症因子神经分子及T细胞亚群的检测分析[J].中国药物与临床,2018,18(11):1952-1954.
[11] Geis C, Planagumà J, Carreño M, et al. Autoimmune seizures and epilepsy[J]. J Clin Invest, 2019, 129(3): 926-940.
[12] 李超,郭旗.细胞因子IL-1β、IL-2、IL-6、IL-8和TNF-α水平在癫痫患者外周血中的变化及其意义[J].解放军预防医学杂志,2018,36(3):375-377, 385.
[13] Zhou Y, Zhang Y, Zhao M, et al. sIL-2R levels predict the spontaneous remission in sarcoidosis[J]. Respir Med, 2020, 171(5): 106115.
[14] Naymagon L, Tremblay D, Troy K, et al. Soluble interleukin-2 receptor(sIL-2r)level is a limited test for the diagnosis of adult secondary hemophagocytic lymphohistiocytosis[J]. Eur J Haematol, 2020, 105(3): 255-261.
[15] Otto C, Wengert O, Unterwalder N, et al. Analysis of soluble interleukin-2 receptor as CSF biomarker for neurosarcoidosis[J]. Neurol Neuroimmunol Neuroinflamm, 2020, 7(4): e725.
[16] 李文涛,李志平,王胜,等.老年脑卒中患者血清炎症因子与焦虑抑郁程度相关性分析[J].国际精神病学杂志,2018,45(4):697-699+703.
[17] 郝立成,边瑞军,张双,等.NSE在颅内感染患儿脑脊液和血清中的含量变化及对化脓性脑膜炎和病毒性脑膜炎的临床意义[J].中国煤炭工业医学杂志,2017,20(10):1193-1195.
[18] 韦倩娜,林诗映,王玲.炎症因子水平与癫痫患者脑电图异常表现的关系研究[J].中国药物与临床,2019,19(3):464-466.
[19] Wang D, Hu B, Dai Y, et al. Serum uric acid is highly associated with epilepsy secondary to cerebral infarction[J]. Neurotox Res, 2019, 35(1): 63-70.
[20] Kandhai-Ragunath JJ, De Wagenaar B, Doelman C, et al. Endothelial function after ST-elevation myocardial infarction in patients with high levels of high-sensitivity CRP and Lp-PLA2: A substudy of the RESPONSE randomized trial[J]. Cardiovasc Revasc Med, 2017, 18(3): 202-206.
[21] Terrone G, Balosso S, Pauletti A, et al. Inflammation and reactive Oxygen species as disease modifiers in epilepsy[J]. Neuropharmacology, 2020, 167(7): 107742.
[22] 颜甘玲,蔡明玲.复方丹参滴丸联合抗癫痫药物对外伤性癫痫患者炎症因子和生化指标的影响[J].现代中西医结合杂志,2019,28(21):2328-2331.

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备注/Memo

备注/Memo:
基金项目:陕西省卫生健康基金项目(编号为20190079)
更新日期/Last Update: 2022-09-10