Abstract:

Background: The cerebrospinal fluid/serum albumin ratio (QAlb) serves as a critical indicator for assessing blood-brain barrier (BBB) permeability. This study aimed to assess BBB permeability in children with drug-resistant epilepsy (DRE) by calculating QAlb and to investigate its correlation with clinical characteristics, as well as its potential as a biological marker. Methods: A total of 35 children diagnosed with DRE (epilepsy group) and 37 children with primary headache (control group) were admitted to The First Affiliated Hospital of Zhengzhou University between June 2018 and June 2023. QAlb values were derived from laboratory test results. Spearman rank correlation analysis was employed to explore the relationship between QAlb and variables such as disease duration, seizure type, seizure frequency, status epilepticus, and the number of antiepileptic seizure medicine (ASM). Results: Compared with control group, the QAlb values were elevated [3.29 (2.39, 4.54) ×10³ vs. 2.15 (1.42, 2.59) ×10³; Z=4.616, P=0.000], and the incidence of BBB dysfunction was higher [28.57% (10/35) vs. 2.70% (1/37); χ²=9.299, P=0.002] in epilepsy group. Spearman rank correlation analysis indicated a positive correlation between QAlb and both seizure frequency (r_s=0.587, P=0.000) and the number of ASM (r_s=0.367, P=0.030) in children with DRE. Conclusions: Some children with DRE exhibit BBB dysfunction. QAlb is positively correlated with seizure frequency and the number of ASM, suggesting its potential as a biological marker for identifying BBB dysfunction.

Key words: Drug resistant epilepsy, Cerebrospinal fluid, Serum albumin, Blood-brain barrier, Child

摘要：

研究背景: 脑脊液/血清白蛋白比值（QAlb）是血脑屏障通透性的评估指标，本研究通过计算QAlb评估药物难治性癫痫患儿血脑屏障通透性，并探讨其与临床特征的相关性及其作为生物学标志物的可行性。方法: 纳入2018年6月至2023年6月郑州大学第一附属医院收治的35例药物难治性癫痫患儿（癫痫组）和37例原发性头痛患儿（对照组），根据实验室检查结果计算QAlb，Spearman秩相关分析探究其与癫痫病程、发作形式、发作频率、癫痫持续状态和抗癫痫发作药物种类的相关性。结果: 癫痫组患儿QAlb高于对照组[3.29（2.39，4.54）×10³对2.15（1.42，2.59）×10³；Z=4.616，P=0.000]，血脑屏障功能障碍发生率亦高于对照组[28.57%（10/35）对2.70%（1/37）；χ²=9.299，P=0.002]。Spearman秩相关分析显示，药物难治性癫痫患儿QAlb与癫痫发作频率（r_s=0.587，P=0.000）和抗癫痫发作药物种类（r_s=0.367，P=0.030）呈正相关。结论: 部分药物难治性癫痫患儿存在血脑屏障功能障碍，QAlb与癫痫发作频率和抗癫痫发作药物种类呈正相关，提示其可作为识别血脑屏障功能障碍的潜在生物学标志物。

关键词: 耐药性癫痫, 脑脊髓液, 血清白蛋白, 血脑屏障, 儿童