摘要
目的研究血清高迁移率族蛋白B1(HMGB1)水平与小儿热性惊厥(FC)临床特征及转为癫痫的相关性。方法采用回顾性分析方法,研究对象为2018年1月至2020年1月右江民族医学院附属医院收治入院的180例FC患儿,将其设定为FC组;同时,选取同期入院的50例发热无惊厥患儿与50例体检健康儿童作为研究对象,分别设定为发热组与健康组。3组均检测HMGB1水平与炎症反应指标[白细胞(WBC)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素1β(IL-1β)]水平。其中FC组患儿随访18个月,详细记录FC患儿的临床特征、癫痫发作率,分析FC诊断中HMGB1检测价值,并分析FC转为癫痫与HMGB1的相关性。结果与发热组、健康组比较,FC组血清HMGB1、炎症反应指标水平更高,差异均有统计学意义(P<0.05);FC组血清HMGB1水平与WBC、CRP、TNF-α、IL-6、IL-1β水平均呈正相关(r=0.247、0.235、0.227、0.173、0.364,P<0.01)。不同惊厥类型、惊厥不同持续时间组间HMGB1水平比较,差异均有统计学意义(P<0.05);HMGB1水平对小儿FC的诊断效能较高[受试者工作特征曲线下面积为0.842(95%CI:0.810~0.872)];与FC未转为癫痫患儿比较,FC转为癫痫患儿的血清HMGB1水平更高,差异有统计学意义(P<0.05),但HMGB1预测FC转为癫痫的诊断效能较低[受试者工作特征曲线下面积为0.595(95%CI:0.543~0.647)];多因素回归分析显示FC转为癫痫中HMGB1并非独立影响因素。结论血清HMGB1水平高低与FC患儿发病、疾病类型及严重程度密切相关,且HMGB1是FC转为癫痫的影响因素之一,但不是独立因素。
Objective To study the correlation between the level of high mobility group B1(HMGB1)and the clinical characteristics of febrile convulsion(FC)in children and its transformation into epilepsy.Methods Retrospective analysis was performed on 180 children with FC who were admitted to Affiliated Hospital of Youjiang Ethnic Medical College from January 2018 to January 2020,and they were assigned to the FC group;At the same time,50 children with fever without convulsion and 50 healthy children with physical examination who were admitted to the hospital during the same period were selected as the research objects,which were respectively set as the fever group and the healthy group.The levels of HMGB1 and inflammatory response indicators[white blood cells(WBC),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin 1β(IL-1β)]were detected in all three groups.The FC group was followed up for 18 months,and the clinical characteristics and epileptic seizure rate of FC children were recorded in detail.The detection value of HMGB1 in the diagnosis of FC was analyzed,and the correlation between FC conversion to epilepsy and HMGB1 was analyzed.Results Compared with fever group and healthy group,serum HMGB1 and inflammatory response indexes of FC group were higher,and the differences were significant(P<0.05).Serum HMGB1 level in FC group was positively correlated with WBC,CRP,TNF-α,IL-6 and IL-1βlevels(r=0.247,0.235,0.227,0.173,0.364,P<0.01).There were significant differences in HMGB1 levels among different types of convulsion and different durations of convulsion(P<0.05).HMGB1 level had a high diagnostic efficiency for FC in children[area under receiver operating characteristic curve was 0.842(95%CI:0.810-0.872)].Compared with children without FC conversion to epilepsy,the serum HMGB1 level of children with FC conversion to epilepsy was higher,and the difference was significant(P<0.05),but the diagnostic efficiency of HMGB1 in predicting FC conversion to epilepsy was lower[area under receive
作者
李东秀
潘彩芬
LI Dong-xiu;PAN Cai-fen(Department of Pediatrics,Affiliated Hospital of Youjiang Ethnic Medical College,Baise Guangxi 533000,China;Baise Maternal and Child Health Hospital,Baise Guangxi 533000,China.)
出处
《临床和实验医学杂志》
2021年第9期927-931,共5页
Journal of Clinical and Experimental Medicine
基金
广西省卫生厅科研课题(编号:18GDO192)。
关键词
热性惊厥
癫痫
高迁移率族蛋白B1
炎症反应
Febrile convulsion
Epilepsy
High mobility group protein B1
Inflammatory response
