癫痫患儿血清脯氨酸肽酶活性、丙二醛水平与注意缺陷多动障碍的关系研究-东南大学学报医学版

癫痫患儿血清脯氨酸肽酶活性、丙二醛水平与注意缺陷多动障碍的关系研究

单位：1. 海口市妇幼保健院儿童保健科, 海南海口 570203;
2. 中南大学湘雅医学院附属海口医院儿科, 海南海口 570203

分类号：R742.1

出版年·卷·期（页码）：2022·41·第二期（192-197）

摘要：

目的:评估血清脯氨酸肽酶(PEPD)活性、丙二醛(MDA)水平变化与癫痫患儿发生注意缺陷多动障碍(ADHD)的关系。方法:选取2020年2月至2021年4月海口市妇幼保健院收治的122例特发性癫痫患儿为研究对象,设为癫痫组,以同期体检健康儿童60例作为对照组;根据是否发生ADHD将癫痫患儿分为ADHD组和无ADHD组。检测所有研究对象的血清PEPD活性、MDA水平及总氧化状态(TOS)、氧化应激指数(OSI)。采用多因素Logistic回归模型和受试者工作特征(ROC)曲线评估血清PEPD活性、MDA水平与ADHD的关系。结果:癫痫组患儿血清PEPD活性、MDA水平、TOS及OSI值均高于对照组(P＜0.05)。ADHD组患儿血清PEPD活性、MDA水平及OSI值均高于无ADHD组(P＜0.05)。ADHD组血清PEPD活性、MDA水平均与OSI值相关(分别r＝0.505、r＝0.595,P＜0.05);血清PEPD活性、MDA水平是影响癫痫患儿ADHD发生风险的独立危险因素(P＜0.05),其诊断癫痫患儿ADHD发生的ROC曲线下面积(AUC)分别为0.817(95%CI为0.741~0.894)、0.760(95%CI为0.674~0.847)。结论:血清PEPD活性及MDA水平升高是癫痫患儿ADHD发病风险增加的独立危险因素。

Objective: To evaluate the relationship between the serum prolidase(PEPD) activity and malondialdehyde(MDA) level and the occurrence of attention deficit hyperactivity disorder(ADHD) in epileptic children. Methods: From February 2020 to April 2021, 122 children with idiopathic epilepsy admitted to our hospital were selected as study subjects, and another 60 healthy children during the same period were selected as control group. According to the occurrence of ADHD, children with epilepsy were divided into ADHD group and non-ADHD group. The PEPD activity, MDA level and total oxidation status(TOS) and oxidative stress index(OSI) were detected. Multivariate Logistic regression model and receiver operating characteristic curve(ROC) were used to analyze the relationship between PEPD activity, MDA level and ADHD in epileptic children. Results: Serum PEPD activity, MDA level, TOS and OSI in epilepsy group were higher than those in the control group(P＜0.05). Serum PEPD activity, MDA level and OSI value in ADHD group were higher than those in non-ADHD group(P＜0.05). In ADHD group, serum PEPD activity and MDA level were correlated with OSI level(r＝0.505, 0.595, P＜0.05). And serum PEPD activity and MDA level were independent risk factors affecting the risk of ADHD in children with epilepsy(P＜0.05). The area under ROC curve of serum PEPD activity and MDA level were 0.817(95%CI0.741-0.894) and 0.760(95%CI0.674-0.847), respectively. Conclusion: Increased serum PEPD activity and MDA level are independent risk factors for ADHD in children with epilepsy.

参考文献：

[1] ELHADY M,YOUNESS E R,MOSTAFA R S I,et al.Oxidative stress contribution to attention deficit hyperactivity disorder in children with epilepsy[J].Appl Neuropsychol Child,2019,8(4):347-354.
[2] 王龙飞,胡春辉,王华.儿童癫痫共患注意缺陷多动障碍临床特征及相关因素分析[J].中国实用儿科杂志,2018,33(4):276-280.
[3] KUL M,UNAL F,KANDEMIR H,et al.Evaluation of oxidative metabolism in child and adolescent patients with attention deficit hyperactivity disorder[J].Psychiatry Investig,2015,12(3):361-366.
[4] AKARİ,İ NCE İ,ASLAN C,et al.Oxidative stress and prolidase enzyme activity in the pathogenesis of primary varicose veins[J].Vascular,2018,26(3):315-321.
[5] LEPARA Z,LEPARA O,FAJKIC A,et al.Serum malondialdehyde(MDA) level as a potential biomarker of cancer progression for patients with bladder cancer[J].Rom J Intern Med,2020,58(3):146-152.
[6] 丁晶,汪昕.癫痫诊疗指南解读[J].临床内科杂志,2016,33(2):142-144.
[7] 黎素清,郑凤丽,谭志军,等.癫痫患儿血清及脑脊液CRP、S100B、NSE含量变化与临床意义[J].现代医学与健康研究,2020,4(5):84-85.
[8] BRIKELL I,GHIRARDI L,D'ONOFRIO B M,et al.Familial liability to epilepsy and attention-deficit/hyperactivity disorder:a nationwide cohort study[J].Biol Psychiatry,2018,83(2):173-180.
[9] CHOUDHARY A,GULATI S,SAGAR R,et al.Childhood epilepsy and ADHD comorbidity in an Indian tertiary medical center outpatient population[J].Sci Rep,2018,8(1):2670.
[10] BAYRAM M,DERIN M E,DOGAN H O,et al.High prolidase levels in patients with Familial Mediterranean Fever(FMF)[J].Rom J Intern Med,2020,58(1):27-33.
[11] AKTURK E,ASKIN L,NACAR H,et al.Association of serum prolidase activity in patients with isolated coronary artery ectasia[J].Anatol J Cardiol,2018,19(2):110-116.
[12] AYAS Z O,KOTAN D,AKDOGAN M,et al.Serum prolidase enzyme activity level:not a predictive biomarker for epilepsy[J].Eurasian J Med,2019,51(1):27-30.
[13] KARACAN N,ÇALIK M,KAZANASMAZ H,et al.The serum prolidase enzyme activity as a biomarker for evaluation of the subclinical vascular damage in children with epilepsy[J].Ann Indian Acad Neurol,2020,23(6):787-791.
[14] RASIC I,RASIC A,AKSAMIJA G,et al.The relationship between serum level of malondialdehyde and progression of colorectal cancer[J].Acta Clin Croat,2018,57(3):411-416.
[15] ABD E L,NABY S A,NAGUIB Y M.Sociodemographic,electrophysiological,and biochemical profiles in children with attention deficit hyperactivity disorder and/or epilepsy[J].Behav Neurol,2018,2018:8932817.
[16] FERREIRA A G K,BIASIBETTI-BRENDLER H,SIDEGUM D S V,et al.Effect of proline on cell death,cell cycle,and oxidative stress in C6 glioma cell line[J].Neurotox Res,2021,39(2):327-334.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录