| 陆婧,张世秀,于春月.血清丙二醛、 25-羟基维生素 D、胱天蛋白酶 9水平联合检测对缺血性脑卒中后癫痫发作的预测价值[J].安徽医药,2026,30(9):1861-1864. |
| 血清丙二醛、 25-羟基维生素 D、胱天蛋白酶 9水平联合检测对缺血性脑卒中后癫痫发作的预测价值 |
| Predictive value of combined detection of serum MDA, 25(OH)D, and caspase-9 levels for epileptic seizures after ischemic stroke |
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| DOI：10.3969/j.issn.1009-6469.2026.09.030 |
| 中文关键词: 脑梗死 脑卒中 癫痫 丙二醛 25-羟基维生素 D 胱天蛋白酶 9 预测 |
| 英文关键词: Cerebral infarction Stroke Epilepsy Malondialdehyde 25 hydroxyvitamin D Caspase-9 Prediction |
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| 中文摘要: |
| 目的探究血清丙二醛、 25-羟基维生素 D［25(OH)D］、胱天蛋白酶 9(caspase-9)水平联合检测对缺血性脑卒中后癫痫发作的预测价值。方法采用随机数字表法，前瞻性收集开滦总医院 2020年 5月至 2023年 5月缺血性脑卒中病人 176例，根据癫痫发作情况将病人分为癫痫组 24例和非癫痫组 152例。采用酶联免疫吸附分析( ELISA)检测丙二醛、 25(OH)D、caspase-9水平，受试者操作特征曲线( ROC曲线)分析血清丙二醛、 25(OH)D、caspase-9水平联合检测对缺血性脑卒中后癫痫发作的预测价值，多因素 logistic回归分析探究缺血性脑卒中后癫痫发作的影响因素。结果癫痫组病人血清中丙二醛［(8.25±1.05)μg/L］、caspase-9［(42.30±5.02)μg/L］水平与非癫痫组［(6.58±0.84)μg/L、(37.58±4.15)μg/L］相比显著升高， 25(OH)D［(12.63±1.42) μg/L］水平与非癫痫组［(14.41±1.63)μg/L］相比显著降低( P<0.05)。丙二醛、 25(OH)D、caspase-9三者联合预测缺血性脑卒中后癫痫发作的曲线下面积( AUC)显著高于血清丙二醛( Z=2.12)、 25(OH)D(Z=2.95)、 caspase-9(Z=2.51)水平单独检测的 AUC值( P<0.05)。多因素 logistic回归分析结果显示，丙二醛( OR=2.15)、 caspase-9(OR=3.62)是影响缺血性脑卒中后癫痫发作的危险因素( P<0.05)，25(OH)D(OR=0.32)是影响缺血性脑卒中后癫痫发作的保护因素( P<0.05)。结论缺血性脑卒中后癫痫发作病人血清中丙二醛、 caspase-9高表达， 25(OH)D低表达，三者联合检测对缺血性脑卒中后癫痫发作有一定的预测价值。 |
| 英文摘要: |
| Objective To investigate the predictive value of combined detection of serum malondialdehyde (MDA), 25-hydroxyvita. min D [25(OH)D] and caspase-9 levels for post-stroke epilepsy in patients with ischemic stroke.Methods A total of 176 patients withischemic stroke admitted to Kailuan General Hospital from May 2020 to May 2023 were prospectively enrolled by random number tablemethod and divided into epilepsy group (24 cases) and non-epilepsy group (152 cases) according to the occurrence of epileptic seizures. Enzyme-linked immunosorbent assay (ELISA) was applied to measure serum levels of MDA, 25(OH)D and caspase-9. Receiver operat.ing characteristic curve (ROC curve) analysis was performed to evaluate the predictive efficacy of single and combined detection of thethree biomarkers for post-stroke epilepsy, and multivariate logistic regression analysis was used to explore the influencing factors of epi.leptic seizures after ischemic stroke.Results Serum levels of MDA [(8.25±1.05) μg/L] and caspase-9 [(42.30±5.02) μg/L] were signifi. cantly higher in the epilepsy group than those in the non-epilepsy group [(6.58±0.84) μg/L and (37.58±4.15) μg/L, respectively], while25(OH)D level [(12.63±1.42) μg/L] was markedly lower in the epilepsy group than that in the non-epilepsy group (14.41±1.63) μg/L (all P<0.05). The area under the curve (AUC) of combined detection of MDA, 25(OH)D and caspase-9 was significantly larger than the AUC of single MDA (Z=2.12), single 25(OH)D (Z=2.95) and single caspase-9(Z=2.51) detection (all P<0.05). Multivariate logistic re. gression analysis demonstrated that elevated MDA (OR=2.15) and caspase-9(OR=3.62) were independent risk factors for post-stroke epilepsy (P<0.05), whereas 25(OH)D (OR=0.32) served as an independent protective factor (P<0.05).Conclusions Patients with post-ischemic stroke epilepsy exhibit elevated serum MDA and caspase-9 as well as reduced 25(OH)D levels. Combined detection of thethree indicators possesses favorable predictive value for epileptic seizures following ischemic stroke. |
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