Serum NSE levels in epileptic patients and its correlation with EEG characteristics and recurrence risk
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摘要:
目的 检测癫痫患者的血清神经元特异性烯醇化酶(NSE)水平，并分析其与脑电图(EEG)特征的相关性，以及癫痫复发风险的预测因素。 方法 选取2021年1月—2023年2月湖州市第一人民医院收治的95例癫痫患者作为研究组，同期选择30例体检健康者作为对照组。采用酶联免疫吸附法检测血清NSE水平，采用Kendall分析血清NSE水平与EEG的相关性；随访1年，根据研究组内癫痫患者是否再次发作分为无复发组(41例)和复发组(52例)，采用多因素logistic回归分析癫痫患者复发的影响因素。 结果 研究组血清NSE、甘丙肽(GAL)及肿瘤坏死因子-α(TNF-α)水平均高于对照组(P < 0.05)；不同EEG异常组血清NSE、GAL及TNF-α水平比较差异均有统计学意义(P < 0.05)。Kendall相关系数分析显示，NSE、GAL及TNF-α与EEG特征(异常程度)呈正相关关系(P < 0.05)。复发组与无复发组抗癫痫药物服药种数、血清NSE、GAL及TNF-α水平比较差异均有统计学意义(P < 0.05)。多因素logistic回归分析显示：NSE(OR=1.259)及TNF-α(OR=1.097)水平高是癫痫患者复发的独立危险因素(P < 0.05)。ROC曲线结果显示：NSE预测癫痫患者复发的AUC为0.859(95% CI：0.786~0.932)，TNF-α的AUC为0.703(95% CI：0.594~0.811)。 结论 血清NSE水平越高，癫痫患者EEG异常程度越高；血清NSE水平对癫痫患者复发风险具有较高的预测价值，可作为癫痫患者复发的独立预测指标。 -
关键词:
- 癫痫 /
- 神经元特异性烯醇化酶 /
- 星形胶质源性蛋白 /
- 脑电图 /
- 复发
Abstract:Objective To detect the level of serum neuron-specific enolase (NSE) in patients with epilepsy, and analyze their correlation with electroencephalogram (EEG) characteristics, as well as identify predictive factors for epilepsy recurrence. Methods A total of 95 epileptic patients admitted to Huzhou First People's Hospital from January 2021 to February 2023 were selected as the research group and 30 healthy people were selected as the control group during the same period. Serum NSE levels were detected by enzyme-linked immunosorbent assay, and the correlation between serum NSE levels and EEG was analyzed by Kendall's correlation. After a one-year follow-up, patients with epilepsy in the research group were divided into a non-recurrence group (n=41) and a recurrence group (n=52). The influencing factors of epilepsy recurrence were analyzed by multivariate logistic regression. Results The levels of serum NSE, galanin (GAL), and TNF-α in the research group were higher than those in the control group (P < 0.05). The levels of serum NSE, GAL, and TNF-α in different EEG abnormal groups were significantly different (P < 0.05). Kendall's correlation analysis showed positive correlations between NSE, GAL, and TNF-α and the degree of EEG abnormality (P < 0.05). The recurrence group showed significant differences in the number of anti-epileptic drugs taken and the levels of serum NSE, GAL, and TNF-α compared to the non-relapse group (P < 0.05). Multivariate logistic regression analysis showed that higher levels of NSE (OR=1.259) and TNF-α (OR=1.097) were independent risk factors for the recurrence of epilepsy (P < 0.05). The ROC curve analysis showed that the AUC of 0.859 (95% CI: 0.786-0.932) for NSE and 0.703 (95% CI: 0.594-0.811) for TNF-α. Conclusion The higher serum NSE levels are associated with higher EEG abnormalities in epileptic patients. Serum NSE levels have a high predictive value for epileptic recurrence and can serve as an independent predictive index of recurrence risk. -
Key words:
- Epilepsy /
- Neuron-specific enolase /
- Astrocyte-derived protein /
- Electroencephalogram /
- Recur
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图 1 血清NSE及TNF-α水平预测癫痫患者复发的ROC曲线
Figure 1. ROC curve of serum NSE and TNF-α levels in predicting the recurrence of epilepsy patients
表 1 对照组与研究组血清NSE、GAL及TNF-α水平比较(x±s)
Table 1. Comparison of serum NSE, GAL, and TNF-α levels between the control group and the research group (x±s)
组别 例数 NSE(μg/L) GAL(ng/L) TNF-α(μg/L) 对照组 30 15.03±2.14 99.25±7.75 8.56±2.27 研究组 95 53.18±7.68 108.72±20.15 63.20±7.95 t值 43.377 3.780 59.722 P值 < 0.001 0.003 < 0.001 
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表 2 不同程度EEG异常组癫痫患者血清NSE、GAL及TNF-α水平比较(x±s)
Table 2. Comparison of serum NSE, GAL and TNF-α levels in different EEG abnormal groups (x±s)
组别 例数 NSE(μg/L) GAL(ng/L) TNF-α(μg/L) 轻度EEG异常组 51 48.29±5.18 97.20±18.53 55.76±8.59 中度EEG异常组 20 50.26±4.56 101.54±19.26 61.30±5.42 重度EEG异常组 24 59.03±5.17 114.29±22.15 69.22±7.16 F值 37.490 6.202 25.267 P值 < 0.001 0.003 < 0.001
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表 3 癫痫患者实验室指标与EEG特征(异常程度)的相关性分析
Table 3. Correlation analysis between laboratory data and EEG characteristics (abnormal degree) of epileptic patients
项目 r值(95% CI) P值 NSE 0.427(0.305~0.572) < 0.001 GAL 0.194(0.073~0.315) 0.012 TNF-α 0.258(0.112~0.390) < 0.001
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表 4 复发组与无复发组癫痫患者一般资料及血清NSE、GAL及TNF-α水平比较
Table 4. Comparison of general data and serum NSE, GAL, and TNF-α levels between the recurrent group and the non-recurrent group
项目 复发组(n=52) 无复发(n=41) 统计量 P值 性别[例(%)] 0.205a 0.651 男性 28(53.85) 24(58.54) 女性 24(46.15) 17(41.46) 年龄(x±s，岁) 46.03±10.22 45.19±9.86 0.401b 0.689 癫痫家族史[例(%)] 1.577a 0.209 有 19(36.54) 10(24.39) 无 33(63.46) 31(75.61) AEDS 服药种数[例(%)] 4.292a 0.038 单药 18(34.62) 23(56.10) 联合用药 34(65.38) 18(43.90) 热惊厥史[例(%)] 0.034a 0.853 有 20(38.46) 15(36.59) 无 32(61.54) 26(63.41) 病程(x±s，年) 5.03±1.35 4.62±1.05 1.647b 0.103 NSE(x±s，μg/L) 62.32±6.14 51.76±6.27 8.138b < 0.001 GAL(x±s，ng/L) 116.20±25.16 105.36±24.29 2.103b 0.038 TNF-α(x±s，μg/L) 65.34±7.56 59.38±7.13 3.897b < 0.001 发作类型[例(%)] 0.997a 0.318 全面性 14(26.92) 15(36.59) 局灶性 38(73.08) 26(63.41) 注：a为χ2值，b为t值。
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表 5 癫痫患者复发的多因素logistic回归分析
Table 5. Multivariate logistic regression analysis on recurrence of epilepsy patients
变量 B SE Waldχ2 P值 OR值 95% CI AEDS 服药种数 -1.110 0.604 3.374 0.066 0.329 0.101~1.077 NSE 0.230 0.052 19.219 < 0.001 1.259 1.136~1.395 GAL -0.014 0.015 0.845 0.358 0.987 0.958~1.015 TNF-α 0.093 0.044 4.483 0.034 1.097 1.007~1.196
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表 6 血清NSE及TNF-α水平的准确性与预测值
Table 6. Accuracy and predictive value of serum NSE and TNF-α levels
项目 AUC 95% CI 灵敏度
(%)特异度
(%)NSE 0.859 0.786~0.932 78.81 78.04 TNF-α 0.703 0.594~0.811 71.22 61.05
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