成人癫痫患者外周血中GADA、ANA水平的变化及其意义

发布时间：2018-02-27 17:55

本文关键词： 癫痫体液免疫 GADA ANA　出处：《大连医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：观察成人癫痫患者外周血中谷氨酸脱羧酶抗体（Anti glutamic aciddecarboxylase antibodies，GADA）、抗核抗体（Anti nuclear antibody，ANA）的水平，分析上述2种自身抗体与成人癫痫发病机制的相关性，探讨体液免疫异常对成人癫痫患者的影响及可能的病理生理机制，，以期防治癫痫提供新的途径。方法：随机选择成人癫痫患者30例为病例组，同期健康体检者30例为正常对照组，符合入组标准，除外排除标准，组间年龄与性别的构成、伴发可疑自身免疫性疾病家族史的情况可比。主要方法为对照研究，根据病因将病例组初步分为隐源性癫痫组（19例）和症状性癫痫组（11例），组间及组内的年龄、性别构成、发作频率及伴发自身免疫性疾病方面具有可比性。分别记录患者的性别、年龄、发病年龄、病程、临床发作类型、发作频率、既往病史、空腹血糖、头部MRI检查等一般情况。所有入组的癫痫患者于入院次日清晨采集空腹外周血后送检，应用酶联免疫吸附法测试外周血GADA及ANA水平。所得结果采用SPSS20.0统计软件分析，对各变量采用正态性检验，两组间定量资料比较，符合正态分布者采用t检验；不符合正态分布者，采用Kruskal-Wallis检测方法。样本率的比较采用χ2检验，当n40或T1时即采用确切概率法。对于两组间的定量资料相关性分析采用Spearman等级相关性分析。比较分析应用两样本均数的t检验、配对t检验及方差分析。对于分类变量采用卡方检验，完成组间差异检验。检验的显著性水准为双侧检验P0.05。结果： 1、成人癫痫患者中，隐源性、症状性癫痫组血清GADA的阳性率（17.6%，10%）较正常对照组显著升高（P=0.0170.05，P=0.0200.05），隐源性癫痫组的GADA阳性率较症状性癫痫组明显升高（χ2=0.556，P=0.0240.05），有统计学意义。症状性癫痫组血清GADA阳性率与病程正性相关（r=0.398，P=0.040.05）。隐源性癫痫组血清GADA阳性率与空腹血糖异常显著正相关（r=0.549，P=0.0030.01）。 2、成人癫痫患者中，隐源性、症状性癫痫组血清ANA阳性率（35.3%，9.1%）较正常对照组显著升高（P=0.0160.05，P=0.0320.05），隐源性癫痫组的ANA阳性率较症状性癫痫组明显升高（χ2=0.151，P=0.0300.05），有统计学意义。两组血清中ANA阳性率与病程正性相关（r=0.109，P=0.0230.05；r=0.071，P=0.0180.05），而成人癫痫患者的ANA阳性率与血糖异常无显著相关。 3、成人癫痫患者血清GADA与ANA阳性率具有显著相关性（χ2=18.987，0.01）。结论： 1、部分成人癫痫患者体内存在体液免疫异常。 2、成人隐源性癫痫患者的体液免疫异常较症状性癫痫多见。 3、GADA与ANA可能协同参与并影响癫痫的病理过程。
[Abstract]:Objective: to observe the levels of anti glutamic aciddecarboxylase antibodiesgardine, anti nuclear antibody Anti nuclear antibody Ana in peripheral blood of adult epileptic patients, and to analyze the correlation between the above two autoantibodies and the pathogenesis of adult epilepsy. To explore the effect of abnormal humoral immunity on adult epileptic patients and its possible pathophysiological mechanism in order to provide a new approach for the prevention and treatment of epilepsy. Methods: 30 adult epileptic patients were randomly selected as the case group and 30 healthy persons as the normal control group, which were in accordance with the criteria of admission, excluding the exclusion criteria, and the composition of age and sex between groups. The family history of suspected autoimmune diseases was compared. The main method was a control study. According to the etiology, the patients were divided into cryptogenic epilepsy group (n = 19) and symptomatic epilepsy group (n = 11). Sex, age, age, course of disease, type of clinical attack, frequency of attack, history of illness, fasting blood glucose were recorded. GADA and ANA levels in peripheral blood were measured by enzyme linked immunosorbent assay (Elisa). The results were analyzed by SPSS20.0 software. The normal test was used for each variable, and the quantitative data between the two groups were compared. T test was used for those who accorded with normal distribution, Kruskal-Wallis test was used for those who did not accord with normal distribution, and 蠂 2 test was used for the comparison of sample rate. When n40 or T1, the exact probability method is used. For the correlation analysis of quantitative data between two groups, the Spearman grade correlation analysis is used. The t test of the mean number of two samples is applied to the comparative analysis. Paired t test and analysis of variance. Chi-square test was used for the classification variables, and the difference test between groups was completed. The significant level of the test was bilateral test (P0.05). Results:. 1. In adult patients with epilepsy, cryptogenic, The positive rate of serum GADA in the symptomatic epilepsy group was significantly higher than that in the normal control group, and the positive rate of GADA in the cryptogenic epilepsy group was significantly higher than that in the symptomatic epilepsy group (蠂 ~ 2 ~ (2) 0.556) P ~ (0.0240.05). The positive rate of serum GADA in the symptomatic epilepsy group was significantly higher than that in the symptomatic epilepsy group. The positive rate of serum GADA in the symptomatic epilepsy group was significantly higher than that in the symptomatic epilepsy group. The positive correlation between serum GADA positive rate and fasting blood glucose abnormality in patients with cryptogenic epilepsy was 0.398 and 0.040.050.The positive rate of serum GADA was positively correlated with fasting blood glucose abnormality in patients with cryptogenic epilepsy (P < 0.05), and there was a significant positive correlation between the positive rate of serum GADA and fasting blood glucose (FBG). 2. In adult patients with epilepsy, cryptogenic, The positive rate of serum ANA in symptomatic epilepsy group was significantly higher than that in normal control group. The positive rate of ANA in cryptogenic epilepsy group was significantly higher than that in symptomatic epilepsy group (蠂 ~ 2 = 0.151). There was statistical significance between ANA positive rate and course of disease in both groups. There was no significant correlation between ANA positive rate and abnormal blood glucose in adult epileptic patients. 3There was a significant correlation between serum GADA and ANA positive rate in adult epileptic patients (蠂 2 + 18.987 0. 01%). Conclusion:. 1. Some adult epileptic patients had abnormal humoral immunity. 2. Abnormal humoral immunity was more common in adult patients with cryptogenic epilepsy than in symptomatic epilepsy. 3 GADA and ANA may be involved in the pathological process of epilepsy.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742.1

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