难治性癫痫患儿血清高迁移率族蛋白1与神经递质含量、认知功能的相关性研究

Correlations of high mobility group box-1 with neurotransmitter content and cognitive function in children with intractable epilepsy

摘要:

目的 探讨难治性癫痫（IEP）患儿血清高迁移率族蛋白1（HMGB-1）与神经递质含量、认知功能的相关性。方法 选取2018年12月—2022年12月江南大学附属医院就诊的82例IEP患儿及抗癫痫药物控制良好的患儿77例，分别作为IEP组、良好组。检测两组血清HMGB-1、5-羟色胺（5-HT）、γ-氨基丁酸（γ-GABA）、去甲肾上腺素（NE）水平；采用中国-韦氏儿童智力量表修订本（C-WISC）评估患儿认知功能。采用Pearson法分析IEP患儿血清HMGB-1与5-HT、γ-GABA、NE含量及C-WISC评分的相关性。采用多因素逐步Logistic回归模型分析导致IEP患儿认知障碍的危险因素。结果 IEP组血清HMGB-1水平较良好组升高（P <0.05），5-HT、γ-GABA、NE水平及C-WISC评分较良好组降低（P <0.05）。Pearson相关性分析显示，IEP组HMGB-1与5-HT、γ-GABA、NE及C-WISC评分均呈负相关（r =-0.683、-0.648、-0.593和-0.608，均P <0.05）。多因素逐步Logistic回归分析结果显示：年龄［O^R=3.080（95% CI：2.014，4.146）］、病程［O^R=5.658（95% CI：1.968，3.076）］、海马硬化［O^R=2.522（95% CI：1.968，3.076）］、合并情感障碍［O^R=1.883（95% CI：1.258，2.509）］和HMGB-1［O^R=3.815（95% CI：1.587，6.043）］是导致IEP患儿认知障碍的危险因素（P <0.05）。结论 IEP患儿血清HMGB-1含量较高，与神经递质含量、认知功能密切相关，其高表达是IEP患儿认知功能障碍的危险因素。

关键词:难治性癫痫;高迁移率族蛋白-1;神经递质;认知功能

Abstract:

Objective To investigate the correlations of blood high mobility group box-1 (HMGB-1) with the neurotransmitter content and cognitive function in children with intractable epilepsy (IEP).Methods From December 2018 to December 2022, eighty-two children with IEP and 77 children with well-controlled epilepsy on antiepileptic drugs were selected as the IEP group and the good group, respectively. Serum levels of HMGB-1, 5-hydroxytryptamine (5-HT), γ-aminobutyric acid (γ-GABA) and norepinephrine (NE) in the two groups were detected. The cognitive function was assessed using the revised Chinese-Wechsler Intelligence Scale for Children (C-WISC). Pearson correlation analysis was performed to determine the correlations of serum HMGB-1 with the contents of 5-HT, γ-GABA, and NE and C-WISC scores in children with IEP. Multivariable stepwise Logistic regression model was used to analyze the risk factors for cognitive function in children with IEP.Results Compared with the good group, the serum level of HMGB-1 was higher (P < 0.05), and the contents of 5-HT, γ-GABA, and NE and C-WISC scores were lower in the IEP group (P < 0.05). Pearson correlation analysis showed that the level of HMGB-1 was negatively correlated with the contents of 5-HT, γ-GABA, and NE and C-WISC scores in the IEP group (r = -0.683, -0.648, -0.593, and -0.608, all P < 0.05). Multivariable Logistic regression analysis demonstrated that advanced age [O^R = 3.080, (95% CI: 2.014, 4.146) ], longer disease course [O^R = 5.658, (95% CI: 1.968, 3.076) ], hippocampal sclerosis [O^R = 2.522, (95% CI: 1.968, 3.076) ], complicating affective disorder [O^R = 1.883, (95% CI: 1.258, 2.509) ] and high levels of HMGB-1 [O^R = 3.815, (95% CI: 1.587, 6.043) ] were all risk factors for cognitive impairment in children with IEP (P < 0.05).Conclusion The level of HMGB-1 is high in children with IEP, and is closely related to the contents of neurotransmitters and cognitive function. The high expression of HMGB-1 is a risk factor for cognitive dysfunction in children with IEP.

Key words:intractable epilepsy;high mobility group protein-1;neurotransmitter;cognitive function