Park Kyung-Il, Hwang Sungeun, Son Hyoshin, Moon Jangsup, Lee Soon-Tae, Jung Keun-Hwa, Jung Ki-Young, Chu Kon, Lee Sang Kun
Department of Neurology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.
Department of Neurology, Seoul National University Healthcare System Gangnam Center, Seoul 06236, Republic of Korea.
J Clin Med. 2024 Sep 18;13(18):5517. doi: 10.3390/jcm13185517.
: Determining the outcome of epilepsy is crucial for making proactive and timely treatment decisions and for counseling patients. Recent research efforts have focused on using various imaging techniques and EEG for prognostication; however, there is insufficient evidence regarding the role of blood parameters. Our study aimed to investigate the additional prognostic value of routine blood parameters in predicting epilepsy outcomes. : We analyzed data from 1782 patients who underwent routine blood tests within 90 days of their first visit and had a minimum follow-up duration of three years. The etiological types were structural (35.1%), genetic (14.2%), immune (4.7%), infectious (2.9%), and unknown (42.6%). The outcome was defined as the presence of seizures in the last year. : Initially, a multivariate analysis was conducted based on clinical variables, MRI data, and EEG data. This analysis revealed that sex, age of onset, referred cases, epileptiform discharge, structural etiology, and the number of antiseizure medications were related to the outcome, with an area under the curve (AUC) of 0.705. Among the blood parameters, fibrinogen, bilirubin, uric acid, and aPTT were significant, with AUCs of 0.602, 0.597, 0.455, and 0.549, respectively. Including these blood parameters in the analysis slightly improved the AUC to 0.710. : Some blood parameters were found to be related to the final outcome, potentially paving the way to understanding the mechanisms of epileptogenesis and drug resistance.
确定癫痫的预后对于做出积极及时的治疗决策以及为患者提供咨询至关重要。最近的研究工作集中在使用各种成像技术和脑电图进行预后评估;然而,关于血液参数的作用,证据并不充分。我们的研究旨在探讨常规血液参数在预测癫痫预后方面的额外预后价值。
我们分析了1782例患者的数据,这些患者在首次就诊后90天内接受了常规血液检查,且随访时间至少为三年。病因类型包括结构性(35.1%)、遗传性(14.2%)、免疫性(4.7%)、感染性(2.9%)和不明原因(42.6%)。结局定义为过去一年中是否有癫痫发作。
最初,基于临床变量、MRI数据和脑电图数据进行了多变量分析。该分析显示,性别、发病年龄、转诊病例、癫痫样放电、结构性病因以及抗癫痫药物的数量与结局相关,曲线下面积(AUC)为0.705。在血液参数中,纤维蛋白原、胆红素、尿酸和活化部分凝血活酶时间(aPTT)具有显著性,AUC分别为0.602、0.597、0.455和0.549。将这些血液参数纳入分析后,AUC略有提高,达到0.710。
发现一些血液参数与最终结局相关,这可能为理解癫痫发生机制和耐药性铺平道路。