Prognostic value of serum hypoxia inducible factor-1α and high mobility group protein 1 levels in patientswith cerebral infarction for secondary epilepsy
Prognostic value of serum hypoxia inducible factor-1α and high mobility group protein 1 levels in patientswith cerebral infarction for secondary epilepsy
代金东 1刘磊 2王静娟 3张国君4
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作者信息
1. 北京市海淀医院(北京大学第三医院海淀院区)神经外科,北京 100086
2. 北京市海淀医院(北京大学第三医院海淀院区)神经内科
3. 首都医科大学宣武医院核医学科
4. 首都医科大学附属北京儿童医院功能神经外科
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摘要
目的 探讨脑梗死患者血清缺氧诱导因子(hypoxia inducible factor,HIF)-1α、高迁移率族蛋白1(high mobility group box protein 1,HMGB1)水平变化对继发性癫痫的预测价值.方法 选取2020年1月至2021年12月北京市海淀医院收治的298例脑梗死患者作为观察组,其中出现癫痫发作42例,无癫痫发作256例;选取同期健康体检者100例为对照组.采用酶联免疫吸附试验检测两组血清HIF-1α、HMGB1水平.采用单因素及多因素logistic回归分析筛选脑梗死后继发癫痫的危险因素.采用受试者工作特征(receiver operating characteristic,ROC)曲线分析危险因素对脑梗死后继发癫痫的诊断效能.结果 观察组血清HIF-1α、HMGB1水平均高于对照组,差异有统计学意义(P<0.01).脑梗死后继发癫痫与无癫痫患者间脑梗死部位、入院时美国国立卫生研究院卒中量表(national insti-tutes of health stroke scale,NIHSS)评分及血清HIF-1α、HMGB1水平比较,差异有统计学意义(P<0.05);两者间性别、年龄、基础疾病、发病至入院时间、入院时Barthel指数比较,差异无统计学意义(P>0.05).多因素logistic回归分析结果显示,脑梗死部位及血清HIF-1α、HMGB1水平均为脑梗死后继发癫痫的危险因素(P<0.001).ROC曲线结果显示,脑梗死部位及血清HIF-1α、HMGB1水平预测脑梗死后继发癫痫的曲线下面积(area under curve,AUC)分别为 0.822、0.762、0.813,三者联合为 0.902,均高于单一参数(P<0.05).结论 血清HIF-1α、HMGB1水平可用于预测脑梗死后继发癫痫,与脑梗死部位联合可提高预测效能.
Abstract
Objective To investigate the predictive value of serum hypoxia inducible factor-1α(HIF-1α)and high mobility group protein 1(HMGB1)levels for secondary epilepsy in patients with cerebral infarc-tion.Methods A total of 298 patients with a cerebral infarction(observation group)who were admitted to the Beijing Haidian Hospital from January 2020 to December 2021 were selected;42 and 256 patients did and did not have seizures,respectively.During the same period,100 healthy patients served as the control group.Serum HIF-1α and HMGB1 levels were determined using a double-antibody sandwich enzyme-linked immunosorbent assay in both groups.Univariate and multivariate logistic regression analysis was used to identify the risk factors for secondary epilepsy after a cerebral infarction.A receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of risk factors for secondary epilepsy after a cerebral infarction.Results The serum HIF-1α and HMGB1 levels in the observation group were higher than the control group(P<0.01).There were significant differences in the site of cerebral infarction,the national institutes of health stroke scale(NIHSS)score at the time of admission,and the serum HIF-1α and HMGB1 levels between patients with and without epilepsy after a cerebral infarction(P<0.05).There were no significant differences in gender,age,underlying diseases,time from symptom onset-to-hospital admission,and Barthel index at the time of admission between the two groups(P>0.05).Multivariate logistic regression analysis showed that the site of cerebral infarction,serum HIF-1α and HMGB1 levels were risk factors for second-ary epilepsy after a cerebral infarction(P<0.01).The area under the ROC curve(AUC)of the cerebral in-farction site,and serum HIF-1α and HMGB1 levels in predicting secondary epilepsy after a cerebral infarc-tion were 0.822,0.762,and 0.813,respectively;the combined value of the three predictive factors was 0.902,which was higher than the single predictive factors(P<0.05).Conclusions Serum HIF-1α and HMGB1 levels can be used to predict secondary epilepsy after a cerebral infarction,and when combined with the site of a cerebral infarction can improve the predictive efficiency.
关键词
脑梗死/癫痫/缺氧诱导因子-1α/高迁移率族蛋白1
Key words
Cerebral infarction/Epilepsy/Hypoxia-inducible factor-1α/High mobility group protein 1
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