A study of the relationship between Neurotrophin-3,LncRNA H1 9 and the severity of persistent status epilepticus in pediatric patients and its predictive efficacy for prognosis
Objective To investigate the relationship between Neurotrophin-3,long non-coding ribonucleic acid H19(LncRNA H19)and the severity of pediatric status epilepticus(SE)and the efficacy in predicting prognosis.Methods One hundred and fifty-two children with SE admitted to the Department of Pediatrics of Yuncheng Central Hospital of Shanxi Medical University from January 2020 to December 2023 were selected as the SE group,and the children with SE were classified into 67 cases in the mild subgroup,52 cases in the moderate subgroup,and 33 cases in the severe subgroup according to the status epilepticus in pediatric severity score(STEPSS);according to the in-hospital outcome,children with SE were divided into good prognosis subgroup of 91 cases and poor prognosis subgroup of 61 cases.Another 60 children were selected for health check-ups in hospitals during the same period as healthy control group.The enzyme-linked immu-nosorbent assay and real-time fluorescence quantitative polymerase chain reaction were used to detect serum Neurotrophin-3 and LncRNA H19 levels;Spearman's method was used to analyze the correlation between serumNeurotrophin-3,LncRNA H19 levels and the STEPSS scores of the children with SE;multifactorial logistic regression analysis was used to analyze the factors influencing poor prognosis in children with SE;the predictive value of serum Neurotrophin-3 and LncRNA H19 lev-els on poor prognosis of pediatric SE was analyzed using receiver operating characteristic(ROC)curves.Results Serum Neurotrophin-3 levels were lower and LncRNA H19 levels were higher in the SE group than in the healthy control group(t/P=11.877/＜0.001,20.966/＜0.001);as the disease aggravated,the serum Neurotrophin-3 levels in the mild subgroup,the moderate subgroup,and the severe subgroup decreased in the order of.LncRNA H19 levels increased sequentially(F/P=184.107/＜0.001,114.394/＜0.001);the incidence of poor prognosis in 152 children with SE was 41.13％(61/152).STEPSS score,SE episode duration ≥ 1h,full-blown seizures,proportion of tracheal intubation,and serum LncRNA H19 levels were higher in the poor prognosis subgroup than in the good prognosis subgroup,and serum Neurotrophin-3 levels were lower than in the good prognosis subgroup(x2/t/P=8.090/＜0.001,11.931/0.001,11.566/0.001,8.752/0.003,6.467/＜0.001,7.846/＜0.001);STEPSS score in children with SE was negatively correlated with serum Neurotrophin-3 levels and positively correla-ted with LncRNA H19 levels(rs/P=-0.764/＜0.001,0.748/＜0.001);multifactorial logistic regression analysis showed that SE episodes lasted for≥1 h,high STEPSS score,full-blown seizures,and high LncRNA H19 were independent risk factors for poor prognosis of pediatric SE[OR(95％CI)=3.216(1.406-7.354),2.001(1.366-2.931),3.970(1.229-11.691),and 1.592(1245-2.034)],and high Neurotrophin-3 was an independent protective factor[OR(95％CI)=0.943(0.919-0.967)];the AUCs of serum Neurotrophin-3,LncRNA H19 levels and the combination of the two for predicting poor prognosis in chil-dren with SE were 0.808,0.780,and 0.891,respectively,and the AUCs of the combination of the two were greater than those predicted by serumNeurotrophin-3 and LncRNA H19 levels alone(Z/P=3.194/0.001,3 521/＜0.001).Conclusion Decreased serum Neurotrophin-3 levels and increased LncRNA H19 levels were associated with exacerbation and poor prognosis in children with SE,and the combination of serum Neurotrophin-3 and LncRNA H19 levels had a high predictive efficacy for poor prognosis in children with SE.
Status epilepticusNeurotrophin-3Long non-coding ribonucleic acid H19SeverityPrognosisDiag-nostic efficacyChildren
维普
万方数据
