目的: 探究脑电图及同型半胱氨酸(homocysteine, Hcy)、25羟维生素D[25(OH)D)]水平在癫痫患儿疗程中的变化及临床意义。方法: 回顾性选取本院2022年1月-2024年1月收治的160例癫痫患儿为研究对象,根据复发情况分为复发组(26例)、未复发组(134例),对比两组发作间期癫痫样放电(interictal epileptiform discharges, IEDs)指数及Hcy、25(OH)D水平;对比两组IEDs指数及Hcy、25(OH)D水平;分析治疗2个疗程后IEDs指数及Hcy、25(OH)D水平与癫痫患儿复发情况的相关性;分析治疗2个疗程后IEDs指数及Hcy、25(OH)D水平对癫痫复发的预测价值。结果: 复发组入院时、治疗2个疗程后,IEDs指数及Hcy水平高于未复发组,血清25(OH)D水平低于未复发组(P＜0.05);治疗2个疗程后,癫痫患儿IEDs指数及血清Hcy水平与其复发情况呈正相关,血清25(OH)D水平与其复发情况呈负相关(P＜0.05);治疗2个疗程后,IEDs指数及血清Hcy水平是患儿癫痫复发的独立危险因素,血清25(OH)D水平是患儿癫痫复发的独立保护因素(P＜0.05);治疗2个疗程后,IEDs指数及血清Hcy、25(OH)D水平联合检测预测患儿癫痫复发的AUC为0.799,约登指数为0.599(P＜0.05)。结论: 脑电图及同型半胱氨酸、25(OH)D水平在癫痫患儿疗程中变化显著,且与患儿复发情况关系密切,各指标联合检测对预测患儿癫痫复发具有一定参考价值。
Objective: To explore the changes and clinical significance of electroencephalogram, homocysteine (Hcy), and 25-hydroxyvitamin D [25(OH)D] level during the treatment of children with epilepsy. Methods: A total of 160 children with epilepsy admitted to our hospital from January 2022 to January 2024 were retrospectively selected as the research objects. According to the recurrence, they were divided into recurrence group (n=26) and non-recurrence group (n=134). The interictal epileptiform discharges (IEDs) index and the levels of Hcy and 25(OH)D were compared between the two groups. IEDs index, Hcy and 25(OH)D levels were compared between the two groups. The correlation between IEDs index, Hcy, 25(OH)D levels and recurrence of children with epilepsy after 2 courses of treatment was analyzed. The predictive value of IEDs index, Hcy and 25(OH)D levels on epilepsy recurrence after 2 courses of treatment was analyzed. Results: On admission and after 2 courses of treatment, the IEDs index and Hcy level in the recurrence group were higher than those in the non-recurrence group, and the serum 25(OH)D level was lower than that in the non-recurrence group (P＜0.05). After 2 courses of treatment, IEDs index and serum Hcy level in children with epilepsy were positively correlated with their recurrence, and serum 25(OH)D level was negatively correlated with their recurrence (P＜0.05). After 2 courses of treatment, IEDs index and serum Hcy level were independent risk factors for epilepsy recurrence in children, and serum 25(OH)D level was an independent protective factor for epilepsy recurrence in children (P＜0.05). After 2 courses of treatment, the AUC of IEDs index combined with serum Hcy and 25(OH)D levels in predicting epilepsy recurrence was 0.799, and the Youden index was 0.599 (P＜0.05). Conclusion: The changes in electroencephalogram, homocysteine, and 25(OH)D levels during the treatment of children with epilepsy are significant, and are closely related to the recurrence of the disease. The combined detection of these indicators has certain reference value for predicting the recurrence of epilepsy in children.
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