广西医学

目的分析特发性癫痫患儿的血清miR-378、miR-575表达情况，并探讨二者与疾病转归的关系。方法将124例特发性癫痫患儿作为癫痫组，150例健康儿童作为健康组。连续随访1年，根据治疗后癫痫发作的控制情况将癫痫患儿分为完全控制组（n=79）和非完全控制组（n=45）。检测所有儿童的血清miR-378、miR-575表达量，评估血清miR-378、miR-575表达量对特发性癫痫患儿发作控制效果的预测效能，并分析特发性癫痫患儿发作控制效果的影响因素。结果癫痫组血清miR-378、miR-575表达量低于健康组（P＜0.05），非完全控制组血清miR-378、miR-575表达量低于完全控制组（P＜0.05）。血清miR-378、miR-575表达量预测特发性癫痫患儿发作控制效果的曲线下面积（AUC）分别为0.747、0.852，二者联合预测的AUC（0.906）大于单一指标的AUC（P＜0.05）。多因素Logistic回归分析结果显示，癫痫发作类型为全身性发作、治疗前癫痫发作频率≥3次/个月、治疗前神经系统发育异常、血清miR-378表达量≤0.73、血清miR-575表达量≤1.83是特发性癫痫患儿发作控制不佳的危险因素（P＜0.05）。结论血清miR-378、miR-575在特发性癫痫患儿血清中呈低表达，且与癫痫发作控制效果有关，二者有望作为预测特发性癫痫患儿发作控制效果的血清学生物标志物。

ObjectiveTo analyze the expressions of serum miR-378 and miR-575 in children with idiopathic epilepsy, and to explore their relations with disease sequelae. MethodsA total of 124 children with idiopathic epilepsy were regarded as epilepsy group, and 150 healthy children as health group. Children were followed up for 1 year, and children with epilepsy were assigned to complete control group (n=79) or incomplete control group (n=45) according to the control of epileptic seizure after treatment. The expressions of serum miR-378 and miR-575 were detected in all children. The predictive efficiency of serum miR-378 and miR-575 expressions for effect of seizure control in children with idiopathic epilepsy was evaluated, and the influencing factors for effect of seizure control in children with idiopathic epilepsy were also analyzed. ResultsThe expressions of serum miR-378 and miR-575 in the epilepsy group were lower than those in the health group (P＜0.05). The expressions of serum miR-378 and miR-575 in the incomplete control group were lower than those in the complete control group (P＜0.05). Areas under the curve (AUC) of serum miR-378 and miR-575 expressions for predicting effect of seizure control in children with idiopathic epilepsy were 0.747 and 0.852, respectively, and AUC (0.906) of the combined prediction of the two was larger than AUC of the single index (P＜0.05). The results of multivariate Logistic regression analysis revealed that generalized seizure as epileptic seizure type, pre-treatment epileptic seizure frequency≥3 times per month, pre-treatment abnormal development of nervous system, serum miR-378 expression≤0.73, serum miR-575 expression≤1.83 were the risk factors for poor seizure control in children with idiopathic epilepsy (P＜0.05). ConclusionSerum miR-378 and miR-575 are low-expressed in children with idiopathic epilepsy, and are related to the effect of epileptic seizure control. Both are expected to be regarded as serological biomarkers to predict effect of seizure control in children with idiopathic epilepsy.