| Convulsion is one of the common clinical emergencies,mostly in children.Convulsion is a disease that causes temporary neurological dysfunction in children under various factors.The incidence rate is about 5%-6%.The continuous and repeated seizure of convulsion can lead to anoxia and ischemic damage of neurons,which can cause certain damage to brain tissue and seriously affect the health and intellectual development of children.Therefore,the evaluation of brain injury caused by convulsion is an important factor to judge the condition and prognosis.At present,neuron-specific enolase(NSE)and insulin-like growth factor-1(IGF-1)have been found to be highly effective in the diagnosis of convulsive episodes.This study will analyze the changes of serum IGF-1 and NSE levels in different degrees of seizure.Objective:To investigate the expression level and clinical significance of insulin-like growth factor 1(IGF-1)and neuron-specific enolase(NSE)in serum after convulsion in children.Methods:From October 2017 to August 2019,135 children with convulsion who were treated in our hospital were selected as the study objects.According to the causes of the attack,they were divided into two groups: febrile convulsion group(66 cases)and epilepsy group(69 cases).At the same time,61 non convulsive children with normal physical examination at the same time were selected as the control group.The NSE and IGF-1 levels in the serum of all subjects were detected by Radioimmunoassay and ELISA,and the diagnostic value of NSE and IGF-1 levels in different degree of seizure was analyzed.Results:1.The serum NSE level of febrile convulsion group was higher than that of the control group(P<0.05),and that of epilepsy group was significantly higher than that of febrile convulsion group(P<0.05).The duration of convulsion≥5min group was higher than that of convulsion<5min group(P<0.05).The number of convulsions≥3 times in group A was higher than that in group B(P < 0.05).2.The serum IGF-1 level in the febrile convulsion group was lower than that in the control group(P<0.05),and that in the epilepsy group was lower than that in the febrile convulsion group(P<0.05).The duration of convulsion≥5min group was lower than that of convulsion<5min group(P<0.05),and the frequency of convulsion≥3 times group was lower than that of convulsion <3 times group(P< 0.05).3.On the 7th day after convulsion,the serum NSE level of each experimental group was lower than that before treatment(P<0.05),and the serum IGF-1 level was higher than that before treatment(P<0.05).On the 7th day after convulsion,there was no significant difference in serum NSE and IGF-1 levels among the experimental groups and the control group(P>0.05).4.There was a negative correlation between serum IGF-1 and NSE(r =-0.476,P<0.05).The AUC of serum NSE and IGF-1 were 0.781 and 0.673,respectively.Conclusions:1.NSE and IGF-1 are involved in the formation of brain injury after seiz-ure.2.The NSE level of epileptic group was higher than that of febrile convul sion group,and the degree of brain injury was more serious than febrile convulsion group.The longer the convulsion lasted,the more frequent the seizure,the higher the NSE level,the more serious the brain injury.3.The serum NSE level was positively correlated with the severity of brain injury after seizure.With the recovery of brain injury,NSE level gradually decreased,which could be used as an early indicator of brain injury after seizure;However,the level of IGF-1 in serum is negatively correlated with the severity of brain injury after seizure.It is concluded that there is neuroprotection in the early stage of seizure.But with the improvement of brain injury,the recovery of neurons requires the decrease of IGF-1,and the level of IGF-1 in blood is higher than that before.Therefore,IGF-1 is expected to be an early treatment after seizure.4.ROC curve showed that NSE and IGF-1 had high sensitivity and specif icity in the evaluation of brain injury caused by convulsion. |
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