外周血BAFF、HMGB1、miR-219a-5p在小儿癫痫中的表达水平及临床意义OA

Objective:To investigate the expression levels and prognostic value of peripheral blood B-cell activating factor of TNF family(BAFF),high-mobility group box-1(HMGB1)and miR-219a-5p in children with epilepsy.Methods:A total of 84 children with epilepsy admitted to Qingdao Municipal Hospital from April 2023 to March 2024 were selected as the epilepsy group,and 84 healthy children receiving physical examinations during the same period were set as the control group.According to the Glasgow Outcome Scale,the epilepsy group was subdivided into a good prognosis subgroup(n=61)and a poor prognosis subgroup(n=23).Baseline data of all subjects were collected.The expression levels of peripheral blood BAFF,HMGB1 and miR-219a-5p were detected by ELISA,fluorescence flow cytometry and qRT-PCR,respectively.The differences in clinical indicators and molecular expression were compared between the two groups and different prognosis subgroups.Multivariate Logistic regression analysis was performed to screen independent risk factors for poor epilepsy prognosis.Spearman correlation analysis was used to analyze the correlations among the three molecular markers,and receiver operating characteristic(ROC)curves were plotted to evaluate the efficacy of combined detection of the three indicators in predicting poor prognosis.Results:The expression levels of BAFF,HMGB1 and miR-219a-5p in the epilepsy group were significantly higher than those in the control group(P＜0.01).The pre-treatment seizure frequency,seizure duration and levels of the three molecular markers in the poor prognosis subgroup were all higher than those in the good prognosis subgroup(all P＜0.01).Logistic regression analysis showed that high pre-treatment seizure frequency,prolonged seizure duration and overexpression of peripheral BAFF,HMGB1 and miR-219a-5p were independent risk factors for poor prognosis of pediatric epilepsy(P＜0.05).Spearman analysis indicated that BAFF,HMGB1 and miR-219a-5p were positively correlated with each other,with correlation coefficients r of 0.468,0.432 and 0.547,respectively(P＜0.05).ROC curve analysis revealed that the area under the curve of the combined three indicators was 0.851,with a sensitivity of 0.87 and a specificity of 0.81,and the predictive efficacy was superior to that of single marker detection(P＜0.05).Conclusion:BAFF,HMGB1 and miR-219a-5p are highly expressed in the peripheral blood of children with epilepsy,and all may serve as independent risk factors for poor prognosis.Combined detection of the three indicators can significantly improve the predictive efficiency of adverse prognosis in pediatric epilepsy.