中山大学孙逸仙纪念医院神经科,广东 广州 510120
叶嘉颖,硕士生,研究方向:癫痫与老年神经疾病,E-mail:229524990@qq.com
收稿:2021-05-18,
纸质出版:2021-11-20
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叶嘉颖,杨炼红.癫痫患者血清高迁移率族蛋白1与TOLL样受体4的表达及影响因素[J].中山大学学报(医学科学版),2021,42(06):839-845.
YE Jia-ying,YANG Lian-hong.Expression of High-mobility Group Box 1, Toll-like Receptor 4 in Epileptic Patients and Analysis of Their Influencing Factors[J].Journal of Sun Yat-sen University(Medical Sciences),2021,42(06):839-845.
叶嘉颖,杨炼红.癫痫患者血清高迁移率族蛋白1与TOLL样受体4的表达及影响因素[J].中山大学学报(医学科学版),2021,42(06):839-845. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2021.0606.
YE Jia-ying,YANG Lian-hong.Expression of High-mobility Group Box 1, Toll-like Receptor 4 in Epileptic Patients and Analysis of Their Influencing Factors[J].Journal of Sun Yat-sen University(Medical Sciences),2021,42(06):839-845. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2021.0606.
目的
2
通过检测癫痫患者血清中高迁移率族蛋白1(HMGB1)与TOLL样受体4(TLR4)的水平并对其进行影响因素分析,探究HMGB1、TLR4在癫痫中的作用和意义,以及影响HMGB1、TLR4表达的因素。
方法
2
本研究为前瞻性观察性临床研究,选取2016年9月至2017年9月期间我院确诊原发性癫痫患者72例为实验组,并分为药物难治组(19例)、药物有效组(32例)、分类不明组(21例)三个亚组;选取同时期我院体检的健康者43例为对照组。采集实验组及对照组研究对象2 mL外周血,留取血清,采用流式荧光检测技术检测血清中HMGB1水平、酶联免疫吸附测定法检测血清中TLR4水平。比较实验组与对照组、实验组亚组间的血清HMGB1、TLR4水平的差异,分析实验组血清HMGB1、TLR4水平的相关性,并对实验组血清HMGB1、TLR4水平与临床因素进行相关性分析。
结果
2
实验组血清HMGB1、TLR4水平分别为(370±211) pg/mL和(36.0±3.8) ng/mL,显著高于对照组的(284±158) pg/mL和(34.4±4.1) ng/mL,差异有统计学意义(
P
<
0.05);药物难治组血清TLR4、HMGB1水平分别为(498±214) pg/mL和(38.4±3.2) ng/mL,显著高于药物有效组的(301±182)pg/mL和(34.5±3.8)ng/mL,差异有统计学意义(
P
<
0.05);实验组血清HMGB1与TLR4的水平呈正相关线性关系,决定系数
R
2
=0.479,
P
<
0.05; 实验组血清HMGB1的水平与癫痫发作频率(
F
=6.71,
P
=0.012)、病程时长(
F
=6.55,
P
=0.013)、药物反应性(
F
=3.96,
P
=0.024)相关,实验组血清TLR4的水平与癫痫发作频率(
F
=4.68,
P
=0.034)、药物反应性(
F
=3.80,
P
=0.027)相关。
结论
2
癫痫患者血清HMGB1、TLR4水平高于非癫痫患者;难治性癫痫(IE)患者血清HMGB1、TLR4水平高于非难治性癫痫患者;癫痫患者血清HMGB1与TLR4水平呈正相关关系; 癫痫患者血清中HMGB1水平与癫痫发作频率、病程时长、药物反应性相关,癫痫患者血清中TLR4水平与癫痫发作频率、药物反应性相关。
Purposes
2
To explore the effect of HMGB1 and TLR4 in epilepsy as well as the influencing factors affecting the expression of HMGB1 and TLR4, we detected the levels of High-mobility group box 1(HMGB1) and Toll-like receptor 4 (TLR4) in serum of epileptic patients and analyzed their influencing factors.
Methods
2
In this prospective observational clinical research, a total of 72 patients who were diagnosed as primary epilepsy in our Hospital from September 2016 to September 2017 were selected as the experimental group and divided into three experimental subgroups: drug-resistant group (19 cases), drug-effective group (32 cases) and unidentified group (21 cases). A total of 43 healthy people in our hospital were selected as the control group. We collected 2 mL of blood from each person in the experimental group and the control group, and separated the serum from blood. The level of HMGB1 in serum was measured by flow fluorescence technology and the level of TLR4 in serum was measured by ELISA. Then, we analyzed the differences of the levels of serum HMGB1 and TLR4 among the experimental group, control group and experimental subgroups, the correlation between the levels of serum HMGB1 and TLR4 of the experimental group, as well as the correlation between the clinical influencing factors and HMGB1 and TLR4.
Results
2
The levels of serum HMGB1 and TLR4 in the experimental group were (370±211) pg/mL and (36.0±3.8) ng/mL, which were significantly higher than (284±158) pg/mL and (34.4±4.1) ng/mL in the control group; and those in the drug-resistant group were (498±214) pg/mL and (38.4±3.2) ng/mL, which were significantly higher than (301±182) pg/mL and (34.5±3.8) ng/mL in the drug-effective group (
P
<
0.05). There was a positive linear correlation between HMGB1 and TLR4 in the experimental group (
R
2
=0.479). The level of serum HMGB1 in the experimental group was related to seizure frequency (
F
=6.71,
P
=0.012), the duration of disease (
F
=6.55,
P
=0.013) and drug reactivity (
F
=3.96,
P
=0.024). The level of serum TLR4 in the experimental group was related to seizure frequency (
F
=4.68,
P
=0.034) and drug reactivity (
F
=3.80,
P
=0.027).
Conclusions
2
The levels of serum HMGB1 and TLR4 in epileptic patients are higher than those of non-epileptic patients. The levels of serum HMGB1 and TLR4 in patients with intractable epilepsy (IE) are higher than those in patients with non-intractable epilepsy. There is a positive correlation between HMGB1 and TLR4. The level of serum HMGB1 in epileptic patients is related to seizure frequency, the duration of disease and drug reactivity. The level of serum TLR4 in epileptic patients is related to seizure frequency and drug reactivity.
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