[1]于 乐,王 沛,姜梦真.癫痫患儿血清基质金属蛋白酶-9、谷氨酸脱羧酶抗体、高迁移率族蛋白B1水平与左乙拉西坦治疗效果相关性及联合检测对治疗效果的预测价值[J].陕西医学杂志,2025,54(3):374-377,383.[doi:DOI:10.3969/j.issn.1000-7377.2025.03.017]
　YU Le,WANG Pei,JIANG Mengzhen.Correlation of serum MMP-9,GADA,HMGB1 levels with therapeutic effect of levetiracetam in children with epilepsy,and predictive value of combined detection for therapeutic effect[J].,2025,54(3):374-377,383.[doi:DOI:10.3969/j.issn.1000-7377.2025.03.017]
点击复制

癫痫患儿血清基质金属蛋白酶-9、谷氨酸脱羧酶抗体、高迁移率族蛋白B1水平与左乙拉西坦治疗效果相关性及联合检测对治疗效果的预测价值
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
54
期数:
2025年3期
页码:
374-377,383
栏目:
药物与临床
出版日期:
2025-03-05

文章信息/Info

Title:
Correlation of serum MMP-9,GADA,HMGB1 levels with therapeutic effect of levetiracetam in children with epilepsy,and predictive value of combined detection for therapeutic effect
作者:
于 乐; 王 沛; 姜梦真
(漯河市中心医院儿科,河南 漯河 462300)
Author(s):
YU Le; WANG Pei; JIANG Mengzhen
(Department of Pediatrics,Luohe Central Hospital,Luohe 462300,China)
关键词:
癫痫;  基质金属蛋白酶-9;  谷氨酸脱羧酶抗体;  高迁移率族蛋白B1;  左乙拉西坦;  预测价值;  儿童
Keywords:
Epilepsy;  Matrix metalloproteinase-9;  Glutamate decarboxylase antibody;  High mobility group protein B1;  Levetiracetam;  Predictive value;  Children
分类号:
R 742.1
DOI:
DOI:10.3969/j.issn.1000-7377.2025.03.017
文献标志码:
A
摘要:
目的:探讨癫痫患儿血清基质金属蛋白酶-9(MMP-9)、谷氨酸脱羧酶抗体(GADA)、高迁移率族蛋白B1(HMGB1)水平与左乙拉西坦治疗效果的相关性及联合检测对治疗效果的预测价值。方法:回顾性选取癫痫患儿98例为癫痫组,选取同期体检健康儿童98例为健康对照组,比较癫痫组与健康对照组入院时血清MMP-9、GADA、HMGB1水平。癫痫患儿均接受左乙拉西坦治疗,根据治疗1年后的疗效分为有效组(65例)和无效组(33例),比较有效组和无效组入院时和治疗1年后血清MMP-9、GADA、HMGB1水平。采用Spearman相关性分析入院时血清MMP-9、GADA、HMGB1水平与癫痫患儿左乙拉西坦治疗效果的相关性。采用受试者工作特征(ROC)曲线分析入院时血清MMP-9、GADA、HMGB1水平联合检测对癫痫患儿治疗效果的预测价值。结果:癫痫组入院时血清MMP-9、GADA、HMGB1水平高于健康对照组(均P<0.05)。有效组与无效组治疗1年后血清MMP-9、GADA、HMGB1水平低于治疗前,且有效组入院时和治疗1年后血清MMP-9、GADA、HMGB1水平低于无效组(均P<0.05)。癫痫患儿入院时血清MMP-9、GADA、HMGB1水平与左乙拉西坦治疗效果呈负相关(均P<0.05)。入院时血清MMP-9、GADA、HMGB1水平联合检测预测癫痫患儿左乙拉西坦治疗无效的曲线下面积(AUC)高于上述指标单项检测(均P<0.05)。结论:癫痫患儿入院时血清MMP-9、GADA、HMGB1水平较高,与左乙拉西坦治疗效果密切相关,早期联合检测可有效预测癫痫患儿左乙拉西坦治疗效果。
Abstract:
Objective:To investigate the correlation of serum levels of matrix metalloproteinase-9(MMP-9),glutamate decarboxylase antibody(GADA),and high mobility group protein B1(HMGB1)with the therapeutic effect of levetiracetam in children with epilepsy,and the predictive value of combined detection for the therapeutic effect.Methods:A total of 98 children with epilepsy were retrospectively selected as epileptic group and 98 healthy children were selected as healthy control group,and serum levels of MMP-9,GADA and HMGB1 were compared between epileptic group and healthy control group at admission.All children with epilepsy received treatment with levetiracetam.After 1 year of treatment,98 children with epilepsy were divided into effective group(65 cases)and ineffective group(33 cases)based on the efficacy,and the serum levels of MMP-9,GADA and HMGB1 at admission and after 1 year of treatment were compared between the effective group and ineffective group.The correlation of serum levels of MMP-9,GADA,HMGB1 at admission with the therapeutic effect of levetiracetam in children with epilepsy was analyzed by Spearman correlation analysis.ROC curve was used to analyze the predictive value of combined detection of serum MMP-9,GADA,and HMGB1 levels at admission for the treatment effect of epilepsy in children.Results:The serum levels of MMP-9,GADA and HMGB1 in the epilepsy group were significantly higher than those in the healthy control group at admission(all P<0.05).After 1 year of treatment,the serum levels of MMP-9,GADA and HMGB1 in the effective group and ineffective group were lower than before treatment,and the serum levels of MMP-9,GADA,and HMGB1 in the effective group were lower than those in the ineffective group at admission and after 1 year of treatment(all P<0.05).The serum levels of MMP-9,GADA and HMGB1 in children with epilepsy were negatively correlated with the therapeutic effect of levetiracetam at admission(all P<0.05).The AUC of serum levels of MMP-9,GADA and HMGB1 combined detection at admission for prediction of the ineffective treatment of levetiracetam in children with epilepsy was higher than individual detection(all P<0.05).Conclusion:The high levels of MMP-9,GADA and HMGB1 in the serum of children with epilepsy at admission are closely related to the therapeutic effect of levetiracetam.Early combined detection can effectively predict the therapeutic effect of levetiracetam in children with epilepsy.

参考文献/References:

[1] 沈玥赤.头皮脑电高频振荡在儿童癫痫中的应用研究进展[J].国际儿科学杂志,2023,50(12):805-809.
[2] POKE G,STANLEY J,SCHEFFER I E,et al.Epidemiology of developmental and epileptic encephalopathy and of intellectual disability and epilepsy in children[J].Neurology,2023,100(13):e1363-e1375.
[3] 季涛云,王若凡,刘庆祝,等.局灶起源的药物难治性癫痫性痉挛的手术预后及相关预后因素分析[J].中华实用儿科临床杂志,2021,36(17):1333-1337.
[4] MARSON A G,BURNSIDE G,APPLETON R,et al.Lamotrigine versus levetiracetam or zonisamide for focal epilepsy and valproate versus levetiracetam for generalised and unclassified epilepsy:Two SANAD Ⅱ non-inferiority RCTs[J].Health Technol Assess,2021,25(75):1-134.
[5] 徐思颖,李信晓,王峰,等.Gabrg2基因敲除促进MMP9表达升高在遗传性癫痫伴热性惊厥附加症中的机制研究[J].宁夏医科大学学报,2021,43(5):433-438.
[6] TAO H,GONG Y,YU Q,et al.Elevated serum matrix metalloproteinase-9,interleukin-6,hypersensitive C-reactive protein,and homocysteine levels in patients with epilepsy[J].J Interferon Cytokine Res,2020,40(3):152-158.
[7] PHUENGJAYAEM S,PAKDEETO A,KINGKAEW E,et al.Genome sequences and functional analysis of levilactobacillus brevis LSF9-1 and pediococcus acidilactici LSF1-1 from fermented fish cake(Som-fak)with gamma-aminobutyric acid(GABA)production[J].Funct Integr Genomics,2023,23(2):158.
[8] 冯娇娇,邢雅杰,刘丹丹,等.AQP4、MMP-9及HMGB1预测癫痫患儿认知功能损害的价值分析[J].中国妇幼健康研究,2023,34(6):28-33.
[9] 李芳,贾晶晶,蒋建华.癫痫患者血清HMGB1、TLR4及IL-1β水平的变化及其对病情严重程度的评估价值[J].海南医学,2023,34(12):1749-1752.
[10] 李世绰,洪震.临床诊疗指南.癫痫病分册[M].北京:人民卫生出版社,2015:24.
[11] 方玲玲,唐久来,吴德,等.张杰辨治小儿难治性癫痫经验总结[J].陕西中医,2020,41(9):1292-1294.
[12] 马金辉,王海燕,杨静云.癫痫患儿认知功能障碍的影响因素及评估方法研究进展[J].医学综述,2023,29(5):953-957.
[13] 谢懂君,吴旭玲,董楝,等.甘露特钠对慢性癫痫大鼠认知功能障碍的影响[J].中国神经精神疾病杂志,2023,49(6):351-356.
[14] CERULLI IRELLI E,COCCHI E,MORANO A,et al.Levetiracetam vs lamotrigine as first-line antiseizure medication in female patients with idiopathic generalized epilepsy[J].JAMA Neurol,2023,80(11):1174-1181.
[15] RAZIEH R,SHAFIEI A,DEHGHANI FIROUZABADI F,et al.Evaluation of the efficacy and tolerability of levetiracetam as add-on therapy in intractable epilepsy of children[J].Iran J Child Neurol,2022,16(2):77-84.
[16] 吕淑娟,王海艳,李梦媛,等.丙戊酸钠联合左乙拉西坦治疗对癫痫患儿智力认知水平及脑电图的影响[J].中国实用神经疾病杂志,2024,27(5):578-582.
[17] MARSON A,BURNSIDE G,APPLETON R,et al.The SANAD Ⅱ study of the effectiveness and cost-effectiveness of valproate versus levetiracetam for newly diagnosed generalised and unclassifiable epilepsy:An open-label,non-inferiority,multicentre,phase 4,randomised controlled trial[J].Lancet,2021,397(10282):1375-1386.
[18] 程伟,包艳娥,李婉秋,等.MMP-9/TIMP-1比值与高血压脑出血病情的相关性研究[J].神经损伤与功能重建,2021,16(9):526-528.
[19] 王婷,梁佳佳.不同TOAST分型急性脑梗死患者血清CXC趋化因子配体16、碱性髓鞘蛋白、基质金属蛋白酶-9水平变化及临床意义[J].陕西医学杂志,2021,50(12):1581-1584.
[20] 罗德钦,刘婷婷,熊青,等.CD147/MMP-9通路与2型糖尿病合并高血压患者发生颈动脉粥样硬化的关系[J].南昌大学学报(医学版),2023,63(2):50-53.
[21] 谢馨,周新平,范进.血清Galectin-3、MMP-9表达与急性缺血性脑卒中患者静脉溶栓治疗后神经功能缺损的相关性[J].中风与神经疾病杂志,2022,39(8):719-722.
[22] PERUCCA E,BIALER M,WHITE H S.New GABA-targeting therapies for the treatment of seizures and epilepsy:Role of GABA as a modulator of seizure activity and recently approved medications acting on the GABA system[J].CNS Drugs,2023,37(9):755-779.
[23] 正玲,宋玉宁,程玉清.小鼠癫痫模型血清谷氨酸脱羧酶抗体和TLR4水平与海马神经元损伤的关系[J].广东医学,2019,40(1):87-90.
[24] 幸黔鲁,白国辉.难治性癫痫患儿血清谷氨酸脱羧酶抗体、神经节苷脂抗体水平变化[J].山东医药,2018,58(27):57-59.
[25] 李冬梅,陈巧彬,陈琅,等.FPS-ZM1和mNGF对癫痫幼鼠脑内HMGB1和TRX表达的影响[J].福建医科大学学报,2021,55(6):513-516.

相似文献/References:

[1]史剑飞,卢北玲,宁远征△.儿童癫痫患者血清胱抑素C表达水平及检测意义*[J].陕西医学杂志,2019,(10):1393.
[2]余明艳,李 芳.尿激酶静脉溶栓治疗对急性轻型脑卒中患者血清脂蛋白相关磷脂酶A2、可溶性血管细胞黏附分子-1、基质金属蛋白酶-9水平及神经功能的影响[J].陕西医学杂志,2021,50(1):79.[doi:DOI:10.3969/j.issn.1000-7377.2021.01.021]
　YU Mingyan,LI Fang.Effects of intravenous thrombolysis with urokinase on Lp-PLA2,sVCAM-1,MMP-9 levels and neurological function in patients with acute mild stroke[J].,2021,50(3):79.[doi:DOI:10.3969/j.issn.1000-7377.2021.01.021]
[3]刘源源.左乙拉西坦治疗成人癫痫疗效及对患者血清脑源性神经营养因子和miR-134-5p的影响[J].陕西医学杂志,2021,50(3):349.[doi:DOI:10.3969/j.issn.1000-7377.2021.03.024]
　LIU Yuanyuan.Efficacy of levetiracetam in treatment of adult epilepsy and its effect on serum BDNF and miR-134-5p[J].,2021,50(3):349.[doi:DOI:10.3969/j.issn.1000-7377.2021.03.024]
[4]包 蕾.阿加曲班联合阿司匹林治疗急性脑梗死疗效及对患者血管内皮功能的影响[J].陕西医学杂志,2021,50(5):603.[doi:DOI:10.3969/j.issn.1000-7377.2021.05.022]
　BAO Lei.Efficacy of agatroban combined with aspirin in treatment of acute cerebral infarction[J].,2021,50(3):603.[doi:DOI:10.3969/j.issn.1000-7377.2021.05.022]
[5]王 婷,梁佳佳.不同TOAST分型急性脑梗死患者血清CXC趋化因子配体16、碱性髓鞘蛋白、基质金属蛋白酶-9水平变化及临床意义[J].陕西医学杂志,2021,50(12):1581.[doi:DOI:10.3969/j.issn.1000-7377.2021.12.029]
　WANG Ting,LIANG Jiajia.Changes and clinical significance of serum CXCL16,MBP and MMP-9 levels in patients with different TOAST subtypes of cerebral infarction[J].,2021,50(3):1581.[doi:DOI:10.3969/j.issn.1000-7377.2021.12.029]
[6]严晓华,王 娜,马 娟,等.阿托伐他汀对小鼠川崎病的治疗作用及机制研究[J].陕西医学杂志,2022,51(6):672.[doi:DOI:10.3969/j.issn.1000-7377.2022.06.007]
　YAN Xiaohua,WANG Na,MA Juan,et al.Therapeutic effect and mechanism of atorvastatin on Kawasaki disease mice[J].,2022,51(3):672.[doi:DOI:10.3969/j.issn.1000-7377.2022.06.007]
[7]张亚琼,姬冬林.奥扎格雷钠对癫痫小鼠应激、神经损伤程度和神经功能重建相关因子及凝血指标的影响[J].陕西医学杂志,2022,51(7):787.[doi:DOI:10.3969/j.issn.1000-7377.2022.07.004]
　ZHANG Yaqiong,JI Donglin.Effects of sodium ozagrel on stress,nerve injury degree,neural function reconstruction related factors and coagulation indexes in epilepsy mice[J].,2022,51(3):787.[doi:DOI:10.3969/j.issn.1000-7377.2022.07.004]
[8]蔺军敏,李春华.血清糖类抗原125及基质金属蛋白酶-9检测在胎盘早剥预测中的价值分析[J].陕西医学杂志,2022,51(10):1305.[doi:DOI:10.3969/j.issn.1000-7377.2022.10.032]
　LIN Junmin,LI Chunhua.Value of serum carbohydrate antigen 125 and matrix metalloproteinase-9 in predicting placental abruption[J].,2022,51(3):1305.[doi:DOI:10.3969/j.issn.1000-7377.2022.10.032]
[9]平 虎,蒲 燕,汤 进,等.心肌型脂肪酸结合蛋白、红细胞分布宽度、半胱氨酸天冬氨酸蛋白酶-3、基质金属蛋白酶-9、胱抑素C、肿瘤坏死因子-α联合检测对急性一氧化碳中毒患者预后的预测价值[J].陕西医学杂志,2022,51(11):1432.[doi:DOI:10.3969/j.issn.1000-7377.2022.11.027]
[10]杨 谦,曹冰清,韩 征,等.CXC趋化因子配体10在癫痫大鼠和细胞炎症反应中的作用及机制研究[J].陕西医学杂志,2022,51(12):1483.[doi:DOI:10.3969/j.issn.1000-7377.2022.12.004]
　YANG Qian,CAO Bingqing,HAN Zheng,et al.Role and mechanism of CXC chemokine ligand-10 in inflammatory response of epileptic rats and cells[J].,2022,51(3):1483.[doi:DOI:10.3969/j.issn.1000-7377.2022.12.004]

备注/Memo

备注/Memo:
[基金项目]河南省医学科技攻关计划联合共建项目(LHGJ20221083)
更新日期/Last Update: 2025-03-05