Relationship between the levels of serum neuron-specific enolase,tumor necrosis factor-α and the prognosis of children with epilepsy secondary to viral encephalitis
Objective To investigate the relationship between the levels of serum neuron-specific enolase(NSE)and tumor necrosis factor alpha(TNF-α)and the attack stage and prognosis of children with epilepsy secondary to viral encephalitis(VE).Methods A total of 96 children with VE admitted to the People's Hospital Affiliated to Inner Mongolia Medical University from January 2015 to January 2020 were selected as the research subjects,and they were divided into the control group(children with VE,n=30)and the observation group(children with epilepsy secondary to VE,n=66).In addition,30 healthy children who underwent physical examination in the hospital during the same period were selected as the health group.The levels of serum NSE and TNF-α in the health group,control group and observation group were compared.Children in the observation group were further divided into the 24h relapse group(n=48)and 24h non-relapse group(n=18)according to the attack of disease within 24h after admission.The levels of serum NSE and TNF-α were compared between the two groups.Pearson correlation was used to analyze the relationship between the levels of NSE,TNF-α and the attack stage of epilepsy secondary to VE.Children in the observation group were divided into the good prognosis group(n=45)and the poor prognosis group(n=21)according to the Glasgow Outcome Scale score at discharge.The serum levels of NSE,TNF-α and other possible prognostic factors were compared between the two groups.Multivariate logistic regression analysis was used to explore the prognostic factors of children with epilepsy secondary to VE,and the predictive value of serum NSE and TNF-αlevels on the prognosis of children with epilepsy secondary to VE was analyzed by drawing the receiver operating characteristic curve.Results The level of serum NSE in the control group was significantly higher than that in the health group(P＜0.05),and there was no significant difference in the level of serum TNF-α between the control group and the health group(P＞0.05).The serum levels of NSE and TNF-α in the observation group were significantly higher than those in the control group(P＜0.05).The serum levels of NSE and TNF-α in the observation group were significantly higher than those in the control group(P＜0.05).The levels of serum NSE and TNF-α in the 24 h relapse group were significantly higher than those in the 24 h non-relapse group(P＜0.05).The proportion of severe abnormal EEG,severe abnormal brain images and complicated respiratory failure,and serum levels of c-reactive protein,NSE and TNF-α in the good prognosis group were lower than those in the poor prognosis group(P＜0.05);there were no significant differences in sex,age,body mass,brain injury site,fever,hypokalemia,hyponatremia,previous convulsions,stress hyperglycemia,complicated organ dysfunction,viral infection,first episode of epilepsy,Glasgow Coma Scale score at admission,duration of convulsion,length of hospital stay,white blood cell count,aspartate transaminase,creatine kinase and cardiac troponin levels between the two groups(P＞0.05).The results of multivariate logistic regression analysis showed that complicated respiratory failure,serum NSE and TNF-α levels were correlated with the prognosis of children with epilepsy secondary to VE(P＜0.05).The area under the curve(AUC)of serum NSE and TNF-α levels in predicting the prognosis of children with epilepsy secondary to VE was 0.724(95％confidence interval:0.672-0.776)and 0.689(95％confidence interval:0.637-0.734),respectively,with a sensitivity of 82.22％and 75.56％and a specificity of 76.19％and 71.43％;the AUC of the combination of the two in predicting the prognosis of children with epilepsy secondary to VE was 0.826(95％confidence interval:0.774-0.873),with a sensitivity of 73.33％and a specificity of 80.95％.Conclusion The serum levels of NSE and TNF-α are abnormally high in children with epilepsy secondary to VE.Both of them are factors affecting the prognosis of children with epilepsy secondary to VE,showing a good predictive value for the prognosis of epilepsy secondary to VE.
维普
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