难治性癫痫患者血清单胺类神经递质及心肌酶变化的研究

发布时间：2018-02-27 10:36

本文关键词： 难治性癫痫单胺类神经递质心肌酶围发作期癫痫猝死　出处：《癫痫杂志》2018年01期 　论文类型：期刊论文

【摘要】：目的探讨难治性癫痫(Refractory epilepsy,RE)患者围发作期及发作间期血清单胺类神经递质及心肌酶变化,了解癫痫发作对心血管系统可能产生的影响,为癫痫猝死的早期预警及预防提供帮助和指导。方法收集2015年12月—2016年12月期间吉林大学第一医院神经内科急诊及住院诊断为RE且观察期间出现癫痫发作的32例患者,分别检测围发作期及发作间期的血清肾上腺素(Epinephrine,EPI)、去甲肾上腺素(Norepinephrine,NE)、多巴胺(Dopamine,DA)、5-羟色胺(5-hydroxytryptamine,5-HT)、肌酸激酶同工酶(Creatine kinase isoenzyme,CKMB)、乳酸脱氢酶(Lactate dehydrogenase,LDH)、羟丁酸脱氢酶(Hydroxybutyrate dehydrogenase,HBDH)。所有数据采用SPSS17.0统计软件进行分析。结果 (1)32例患者男女比例21:11,年龄15~85岁,平均年龄(50.9±17.6)岁;60岁的共12例(37.5%),60岁的共20例(62.5%);癫痫病史1~14年,平均(3.75±3.12年);(2)RE患者围发作期血清EPI、LDH含量低于发作间期,血清NE、DA含量高于发作间期;(3)60岁以下患者围发作期血清EPI、NE、DA含量高于60岁以上患者;(4)按病因分成特发性癫痫组10例(31.25%),脑炎后癫痫组7例(21.88%),卒中后癫痫组9例(28.12%),脑损伤后癫痫组6例(18.75%)。显示卒中后癫痫组患者的血清EPI、NE、DA的围发作期含量明显低于另外三组;特发性癫痫组血清CKMB围发作期含量高于卒中后癫痫及脑损伤后癫痫患者。余组间对比无统计学差异。结论 RE患者癫痫发作可能引起交感神经兴奋性增高,在中青年患者中更为明显,可能与中青年癫痫猝死发生率高相关;卒中后癫痫患者发作时交感神经兴奋性相对较低,可能对心脏损伤相对较小。
[Abstract]:Objective to investigate the changes of amine-like neurotransmitters and myocardial enzymes in patients with refractory epilepsy (Refractory epepsyl) during peri- and interictal period, and to understand the possible effects of epilepsy on the cardiovascular system. Methods from December 2015 to December 2016, 32 patients who were diagnosed as RE in emergency department of neurology and hospitalized in the first Hospital of Jilin University and who had epileptic seizures during observation were collected, which were helpful and instructive for early warning and prevention of sudden Epilepsy death (SCD). The serum levels of epinephrine, norepinephrine, dopamine Dopamine, 5-hydroxytryptamine, creatine kinase isoenzyme creatine kinase isoenzyme, lactate dehydrogenate and hydroxybutyrate dehydrogenase were detected in periictal and interictal phases, respectively. All data were collected by SPSS17.0 statistics. Results the male to female ratio of 32 patients was 21: 11, aged 15 to 85 years. The mean age was 50.9 卤17.6 years old, 12 patients with 60 years old or 60 years old, 20 patients with 60 years old, 20 patients with epilepsy history from 1 to 14 years, the mean value of serum EPIN LDH in the patients with epilepsy was 3.75 卤3.12 years, the content of serum EPIN LDH was lower than that in the interictal period. The content of serum NEDA was higher than that of patients under 60 years of age in interictal period. The content of serum EPII-NEDA in patients under 60 years old was higher than that in patients over 60 years old.) according to the etiology, it was divided into 10 cases of idiopathic epilepsy group (n = 10), 7 cases of post-encephalitis epilepsy group (n = 7), 9 cases of post-stroke epilepsy group (n = 9), and brain injury (n = 10). In the post epilepsy group, the serum EPINDA levels in 6 patients with post-stroke epilepsy were significantly lower than those in the other three groups. The level of serum CKMB in patients with idiopathic epilepsy was higher than that in patients with epilepsy after stroke and brain injury. There was no significant difference between the other groups. Conclusion seizures in patients with RE may lead to the increase of sympathetic excitability. It is more obvious in young and middle-aged patients, which may be related to the incidence of sudden death of epilepsy in young and middle-aged patients, and the sympathetic nerve excitability is relatively low and the cardiac injury may be relatively small in patients with post-stroke epilepsy.
【作者单位】：吉林大学第一医院神经内科和神经科学中心;
【分类号】：R742.1

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