血液学指标在癫痫持续状态患儿中的改变及其临床意义

目的：分析血液学指标在癫痫持续状态患儿中的改变及其临床意义。方法：分析2013年1月-2015年1月在某院接受治疗的癫痫持续状态患儿（观察组）及癫痫患儿（对照组）的临床资料。结果：本研究共纳入患儿108例，其中观察组52例，对照组56例。观察组患儿外周血肿瘤坏死因子-α（TNF-α）水平显著高于对照组，差异具有统计学意义（t=7.285，P<0.001）；观察组患儿外周血神经肽Y（NPY）（t=5.905，P<0.001）及甘丙肽（GAL）（t=6.399，P<0.001）水平显著低于对照组。Pearson相关性分析显示，GAL（r=-0.803，P<0.001）、NPY（r=-0.731，P<0.001）和TNF-α水平间均呈现显著负相关；GAL与NPY间呈现显著正相关，具有统计学意义（r=0.720，P<0.001）。ROC曲线分析显示：以17.2 ng·L^-1为截点值，TNF-α诊断癫痫持续状态的敏感性为90.38%，特异性为78.57%，曲线下面积为0.90。结论：癫痫持续状态患儿外周血NPY、GAL及TNF-α水平升高，TNF-α对癫痫及癫痫持续状态的区分诊断具有一定价值。

Changes of hematological parameters and their clinical significance in pediatric patients under status epilepticus

OBJECTIVE To analyze the changes of hematological parameters and their clinical significance in pediatric patients under status epilepticus. METHODS Clinical data of pediatric patients with epilepsy treated at a hospital from 2013 to 2015 were analyzed. Patients were divided into group A of patients under status epilepticus and group B of patients with epilepsy. RESULTS Totally 108 patients were analyzed, including 52 in group A and 56 in group B. Patients in group A had a higher level of TNF-α (t=7.285, P<0.001), but lower levels of NPY (t=5.905, P<0.001) and GAL (t=6.399, P<0.001) than those of group B. Correlation analysis showed that, for patients in group A, levels of TNF-α had significant negative correlation with GAL (r=-0.803, P<0.001) and NPY (r=-0.731, P<0.001), while GAL had a significant positive correlation with NPY (r=0.720, P<0.001). ROC analysis showed that the TNF-α cut-off point value of 17.2 ng·L^-1, as used for the diagnosis of status epilepticus, provided a sensitivity of 90.38%, a specificity of 78.57%, and an AUC of 0.90, superior to those of NPY and GAL. CONCLUSION The levels of NPY, GAL and TNF-α are increased in patients under status epilepticus and the level of TNF-α has a diagnostic value for status epilepticus.