标题：原发性癫痫患者血清BAFF、HMGB1、TLR4的表达水平及其临床意义

      作者：陈小妮，谭会会，殷艳玲，陈蕊    西安市第三医院神经内科，陕西 西安 710021

      卷次： 2023年34卷4期

      【摘要】 目的 检测原发性癫痫患者血清Ｂ细胞活化因子(BAFF)、高迁移率蛋白1 (HMGB1)、TOLL样受体4(TLR4)的表达水平，并探讨其临床意义。方法 选择 2018年 3月至 2021年 3月西安市第三医院神经内科收治的90例原发性癫痫患者进行研究(观察组)，并选择同期于我院体检的90例健康人员作为对照组。比较两组受检者血清BAFF、HMGB1和TLR4的表达水平及简易精神状态检查量表(MMSE)评分、简明精神病评定量表(BPRS)评分，并比较不同发作类型患者的血清BAFF、HMGB1、TLR4水平及MMSE、BPRS评分，采用Pearson相关分析法分析血清BAFF、HMGB1、TLR4水平与MMSE、BPRS评分的相关性。结果 观察组患者的血清BAFF、HMGB1、TLR4水平及BPRS评分分别为(10.51±1.27) ng/mL、(370.68±75.20) pg/mL、(48.49±9.01) ng/mL、(35.18±4.26)分，明显高于对照组的(4.45±0.60) ng/mL、(282.02±36.24) pg/ mL、(33.15±4.70) ng/mL、(16.87±1.15)分，MMSE评分为(13.28±1.63)分，明显低于对照组的(27.45±2.29)分，差异均有统计学意义(P<0.05)；全身强直阵挛发作患者的血清BAFF、HMGB1、TLR4水平及BPRS评分水平分别为(20.25±4.20) ng/mL、(442.45±97.61) pg/mL、(53.09±10.25) ng/mL、(37.02±3.11)分，明显高于部分性发作患者的(12.82±2.93) ng/ mL、(385.50±80.02) pg/mL、(46.37±7.12) ng/mL、(33.80±3.40)分，MMSE评分为(12.30±2.49)分，明显低于部分性发作患者的(14.28±3.24)分，差异均有统计学意义(P<0.05)；经Pearson相关分析结果显示，血清BAFF、HMGB1、TLR4水平与MMSE评分均呈负相关(r=-0.510、-0.212、-0.306，P<0.05)，与BPRS评分均呈正相关(r=0.391、0.370、0.235，P<0.05)。结论 原发性癫痫患者的血清BAFF、HMGB1、TLR4水平呈高表达，影响患者的精神状态与病情的发展，对临床评估病情及治疗具有指导意义。
      【关键词】 原发性癫痫；Ｂ细胞活化因子；高迁移率蛋白1；TOLL样受体4；相关性
      【中图分类号】 R742.1 【文献标识码】 A 【文章编号】 1003—6350（2023）04—0550—04

Expression and clinical significance of serum B-cell activating factor, high mobility group protein 1, and TOLLlike receptor 4 in patients with primary epilepsy.
CHEN Xiao-ni, TAN Hui-hui, YIN Yan-ling, CHEN Rui. Departmentof Neurology, Xi'an Third Hospital, Xi'an 710021, Shaanxi, CHINA
【Abstract】 Objective To detect the expression levels of serum B-cell activating factor (BAFF), high mobilitygroup protein 1 (HMGB1), and TOLL like receptor 4 (TLR4) in patients with primary epilepsy, and to explore its clinicalsignificance. Methods A total of 90 patients with primary epilepsy admitted to the Department of Neurology, Xi 'anThird Hospital from March 2018 to March 2021 were selected for study (observation group), and 90 healthy people whounderwent physical examination during the same period were selected as a control group. The expression levels of serumBAFF, HMGB1, TLR4, Mini-Mental State Examination (MMSE) score and Brief Psychiatric Rating Scale (BPRS) scorewere compared between the two groups, and the serum levels of BAFF, HMGB1, TLR4, MMSE and BPRS scores of pa-tients with different attack types were compared. Pearson correlation analysis was used to analyze the correlation be-tween serum BAFF, HMGB1, TLR4 levels and MMSE, BPRS scores. Results The levels of serum BAFF, HMGB1,TLR4, and BPRS score in the observation group were (10.51±1.27) ng/mL, (370.68±75.20) pg/mL, (48.49±9.01) ng/mL,and (35.18±4.26) points, which were significantly higher than (4.45±0.60) ng/mL, (282.02±36.24) pg/mL, (33.15±4.70) ng/mL, (16.87±1.15) points in the control group, and the MMSE score was (13.28±1.63) points, significantly low-er than (27.45±2.29) points in the control group (P<0.05). The levels of serum BAFF, HMGB1, TLR4, and BPRS scorein patients with generalized tonic-clonic seizures were (20.25±4.20) ng/mL, (442.45±97.61) pg/mL, (53.09±10.25) ng/mL,(37.02±3.11) points, which were significantly higher than (12.82±2.93) ng/mL, (385.50±80.02) pg/mL, (46.37±7.12) ng/mL,(33.80±3.40) points in patients with partial seizures, and the MMSE score was (12.30±2.49) points, significantly lowerthan (14.28 ± 3.24) points in patients with partial seizures (P<0.05). Pearson correlation analysis showed that serumBAFF, HMGB1, TLR4 levels were negatively correlated with MMSE score, and BPRS score was positively correlated(r=-0.510, -0.212, -0.306, P<0.05). Conclusion Serum BAFF, HMGB1, and TLR4 levels in patients with primary ep-ilepsy were highly expressed, which affected the mental state and the development of the disease, and have guiding sig-nificance for clinical evaluation and treatment.
      【Key words】 Primary epilepsy; B-cell activating factor; High mobility group protein 1; TOLL-like receptor 4;Correlation