2024 年第 11 期 第 19 卷

血清内脂素和脂联素水平与小儿热性惊厥临床特征及转为癫痫的相关性

Correlation of serum visfatin and adiponectin levels with clinical features of pediatric febrile seizures and conversion to epilepsy

作者：陈雅雯1王意嫄1查晓雯1李蕾1向根芳1胡燕2谭小飞2

英文作者：Chen Yawen1 Wang Yiyuan1 Zha Xiaowen1 Li Lei1 Xiang Genfang1 Hu Yan2 Tan Xiaofei2

单位：1湖南中医药大学第一附属医院急诊科，长沙410021；2湖南中医药大学第一附属医院儿科，长沙410021

英文单位：1Department of Emergency the First Hospital of Hunan University of Chinese Medicine Changsha 410021 China; 2Department of Pediatrics the First Hospital of Hunan University of Chinese Medicine Changsha 410021 China

关键词：小儿热性惊厥；癫痫；内脂素；脂联素

英文关键词：

• 摘要：

• 目的 探讨血清内脂素和脂联素水平与小儿热性惊厥临床特征及转为癫痫的相关性。方法 选取2021年1月至2023年6月湖南中医药大学第一附属医院急诊科收治的228例热性惊厥患儿为热性惊厥组，另选取同期114例发热患儿和114名健康儿童分别为发热组和对照组。比较3组患者血清内脂素和脂联素水平。采用Logistic回归方法分析小儿热性惊厥转为癫痫的影响因素。采用受试者工作特征曲线评价血清内脂素、脂联素水平对小儿热性惊厥转为癫痫的预测价值。结果 对照组、发热组、热性惊厥组血清内脂素水平依次降低，脂联素水平依次升高（均P＜0.05）。血清内脂素和脂联素水平与小儿热性惊厥类型、惊厥持续时间、24 h内惊厥次数均有关（均P＜0.05）。随访1年，228例热性惊厥患儿转为癫痫的发生率为25.0%（57/228）。复杂性热性惊厥、惊厥持续时间≥15 min、24 h内惊厥次数≥2次、脂联素水平高均为小儿热性惊厥转为癫痫的独立危险因素，内脂素水平高为独立保护因素（均P＜0.05）。血清内脂素联合脂联素水平预测小儿热性惊厥转为癫痫的曲线下面积为0.872，大于血清内脂素和脂联素水平单独预测的0.787和0.790（均P＜0.05）。结论 血清内脂素水平降低和脂联素水平升高与小儿热性惊厥类型、惊厥持续时间、惊厥次数均有关，是影响热性惊厥转为癫痫的独立因素，二者联合预测小儿热性惊厥转为癫痫的价值较高。

• Objective To investigate the correlation of serum visfatin and adiponectin levels with clinical features of pediatric febrile seizures(FS) and conversion to epilepsy. Methods A total of 228 children with FS admitted to Department of Emergency, the First Hospital of Hunan University of Chinese Medicine from January 2021 to June 2023 were selected as the FS group, and 114 children with fever and 114 healthy children during the same period were selected as the fever group and the control group, respectively. The serum levels of visfatin and adiponectin were compared among the three groups. Logistic regression was used to analyze the influencing factors of FS converting to epilepsy. The receiver operating characteristic curve was used to evaluate the predictive value of serum visfatin and adiponectin levels for the conversion of FS to epilepsy in children. Results The serum level of visfatin in the control group, fever group and FS group decreased in turn, and the serum level of adiponectin increased in turn in the control group, fever group and FS group (all P＜0.05). The serum levels of visfatin and adiponectin were related to the type of FS, the duration of seizures, and the number of seizures within 24 h (all P＜0.05). After 1 year of follow-up, the incidence of epilepsy in 228 FS children was 25.0%(57/228). Complex FS, the duration of seizure ≥15 min, the number of seizure within 24 h ≥2, and high level of adiponectin were independent risk factors for the conversion of FS to epilepsy, and high level of visfatin was an independent protective factor (all P＜0.05). The area under the curve of serum visfatin combined with adiponectin in predicting FS to epilepsy was 0.872, which was larger than 0.787 and 0.790 predicted by serum visfatin or adiponectin alone (both P＜0.05). Conclusions The decreased level of serum visfatin and the increased level of serum adiponectin are related to the type of FS, the duration and frequency of seizures in children, and are independent factors affecting the conversion of FS to epilepsy. The combination of visfatin and adiponectin has a high value in predicting the conversion of FS to epilepsy in children.