癫痫发作患者血清Nesfatin-1动态变化及其对评估病情和短期预后的临床价值

doi:10.13481/j.1671-587x.20190120

摘要/Abstract

摘要： 目的：分析癫痫持续状态（SE）患者血清新饱食分子蛋白1（Nesfatin-1）动态变化趋势，探讨血清Nesfatin-1水平对评估癫痫发作患者病情严重程度及短期预后的临床价值。方法：选择43例原发性癫痫发作患者作为研究对象，均予以积极临床治疗，于治疗前及治疗第1周末、第2周末和第1个月末分别检测每位患者血清Nesfatin-1水平，同时应用利物浦痫性发作严重程度量表（LSSS2.0）对患者进行评估。分析每个时间点患者血清Nesfatin-1水平与LSSS评分的相关性。随访1年根据预后将癫痫发作患者分为生存组（31例）和死亡组（12例）。应用多元Logistic回归分析方法分析随访1年患者预后不良的危险因素，应用受试者工作特征（ROC）曲线评估采用患者血清Nesfatin-1水平预测原发性癫痫发作患者随访1年预后结局的特异度和敏感度。结果：与治疗前比较，随着治疗时间增加，2组患者LSSS评分和血清Nesfatin-1水平呈进行性降低（P<0.01），治疗前2组患者LSSS评分和血清Nesfatin-1水平比较差异无统计学意义（P>0.05）；治疗后第1周末至第1个月末，生存组SE患者LSSS评分和血清Nesfatin-1水平均低于死亡组（P<0.05或P<0.01）。每个时间点患者血清Nesfatin-1水平与LSSS评分均呈正相关关系（r=0.617~0.726，P<0.05）。多元Logistic回归分析，患者血清高水平Nesfatin-1是随访1年癫痫发作患者预后不良危险因素（P<0.05）。ROC曲线评估，血清Nesfatin-1水平对随访1年癫痫发作患者预后不良有明显预测价值（P<0.05）；血清Nesfatin-1水平切点为2.7μg·L^-1时其预测随访1年癫痫发作患者预后不良的灵敏度为88.5%，特异度为79.6%。结论：血清Nesfatin-1水平能有效反映癫痫发作患者病情严重程度，且随治疗时间的延长进行性降低，对癫痫发作患者预后判断有较高的应用价值。

关键词: 新饱食分子蛋白1, 癫痫发作, 病情程度, 预后

Abstract: Objective: To analyze the dynamic variety of serum Nesfatin-1 in the patients with status epilepticus(SE), and to explore the clinical values of the serum Nesfatin-1 in evaluation on the illness condition and short-term prognosis in the patients with epileptic seizure.Methods: A total of 43 patients diagnosed as primary epilepsy were collected as the subjects and received the regular clinical therapy. The serum levels of Nesfatin-1 of the patients were detected before treatment and at the end of the 1st week after treatment, the end of the 2nd week therapy after treatment and the end of the 1st month after treatment, respectively. Liverpool Seizure Severity Scale 2.0 (LSSS2.0) was used to evaluate in the patients. The correlations of the serum levels of Nesfatin-1 of the patients at each time point with the scores of LSSS were analyzed.After one year of follow-up, all patients were divided into two groups according to the prognosis, which were survival group (31 cases) and death group (12 cases). The risk factors of one-year prognosis were analyzed by multivariate Logistic regression analysis. The sensitivity and specificity of the serum values of Nesfatin-1 to the one-year prognosis were analyzed by receiver operating characteristic (ROC) curve.Results: Compared with before treatment, the LSSS scores and the serum Nesfatin-1 levels of the patients in two groups were decreased with the increasing of treatment time (P<0.05). The LSSS scores and the serum levels of Nesfatin-1 of the patients were not different between two groups before treatment (P>0.05).The LSSS scores and the serum levels of Nesfatin-1 of the SE patients in survival group were lower than these in death group from the end of the 1st week after treatment to the end of the 1st month after treatment (P<0.05 or P<0.01). The positive correlations of the serum levels of Nesfatin-1 and the LSSS scores of the patients at each time point were confirmed (r=0.617-0.726,P<0.05).The serum high level of Nesfatin-1 was the risk factor of the one-year prognosis analyzed by multivariate Logistic regression analysis. The ROC curve identified the cutoff level of serum Nesfatin-1 (2.7μg·L^-1) to the one-year prognosis with the sensitivity of 88.5% and specificity of 79.6%.Conclusion: The dynamic variety of serum Nesfatin-1 can reflect the condition of illness, and the serum level of Nesfatin-1 is decreased gradually with the prolongation of time, and has application value in predicting the prognosis of the patients with epileptic seizure.

Key words: Nesfatin-1, epileptic seizure, illness condition, prognosis

中图分类号:

R742.1

陈敏, 谢明, 万娟. 癫痫发作患者血清Nesfatin-1动态变化及其对评估病情和短期预后的临床价值[J]. 吉林大学学报(医学版), 2019, 45(01): 105-110.

CHEN Min, XIE Ming, WAN Juan. Dynamic variety of serum Nesfatin-1 and its clinical values in evaluation on illness condition and short-term prognosis in patients with epileptic seizure[J]. Journal of Jilin University(Medicine Edition), 2019, 45(01): 105-110.

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