血Ghrelin水平在癫痫患者中的变化及意义

发布时间：2018-12-28 09:34

【摘要】：目的：癫痫(Epilepsy)是由大脑神经元异常放电引起的以短暂性中枢神经系统功能失常为特征的慢性脑部疾病,以神经功能失常为特征,反复发作,严重影响患者的生命质量。癫痫发病机制复杂,研究证实癫痫患者神经内分泌系统发生变化,其原因不详,可能与肽类激素ghrelin有关。Ghrelin是一种含有28个氨基酸的生长激素释放肽,主要由胃底X／A样内分泌细胞分泌,并广泛分布于垂体、下丘脑等组织器官。本文通过研究癫痫患者ghrelin的变化特征,初步探讨其表达意义,以期在癫痫诊治和疗效评估中建立更为便捷、敏感的方法,为更深入的研究癫痫发病机制提供理论依据,为临床治疗提供新思路。方法：选取特发性癫痫患者40人,分成两组：全面性发作组(Primary generalized seizure, PGE)18人,男7人,女11人,年龄23～42岁,病程6个月～30年,其中8人为新诊断,入组时未应用药物治疗,其余10人已应用丙戊酸钠治疗3个月以上；部分性发作组(Partial seizure, PE)22人,男9人,女13人,年龄24～43岁,病程6个月-30年,其中8人为新诊断,入组时未应用药物治疗,其余16人已应用卡马西平治疗3个月以上；并选取健康体检者28人作为正常对照组,男12人,女16人,年龄25～43岁。以标准方法测量各研究对象身高、体重,计算体重指数,应用酶联免疫吸附试验(Enzyme-linked immunoadsorbent assay, ELISA)检测患者空腹血清Ghrelin水平,同步测定血.糖(Fasting blood glucose, FBG)、甘油三酯(Triglyceride, TG)、总胆固醇(Total cholestero1)、高密度脂蛋白胆固醇(High-density lipoprotein cholesterol, HDL-c)、低密度脂蛋白胆固醇(Low-density lipoprotein cholesterol, LDL-c),搜集临床资料,分析一般临床特征包括：年龄、性别、体重指数等,并与正常对照组比较,进行统计学分析。结果： 1.特发性癫痫组血清Ghrelin浓度为44.35±11.07pg/ml,对照组为75.37±8.52pg/ml。特发性癫痫组血清Ghrelin水平较对照组明显降低,差异有统计学意义(P0.05), 2.部分性发作组血清Ghrel in浓度为50.52±9.55pg/ml,较全面性发作组ghrelin水平(37.39±7.89pg/m1)升高,差异有统计学意义。 3.全面性发作癫痫丙戊酸钠治疗后组Ghrelin浓度为39.86±6.22pg/ml,较全面性发作未治疗组30.31±3.47pg/ml升高,但仍较对照组低,差异有统计学意义(P0.05)。 4.部分性发作癫痫组卡马西平治疗后组Ghrelin浓度为55.45±5.21pg/ml,较全面性发作未治疗组41.88±9.46pg/ml升高,但仍较对照组低,差异有统计学意义(P0.05)。结论：1.特发性癫痫患者血清Ghrelin水平低于正常,部分性发作癫痫组Ghrelin水平较全面性发作癫痫组水平高,提示Ghrelin可能在癫痫发作中起重要作用。 2.全面性发作癫痫组经丙戊酸钠治疗组Ghrelin水平较全面性发作未治疗组升高,部分性发作卡马西平治疗组Ghrelin水平较部分性发作未治疗组升高,提示高的Ghrelin水平可能有抗癫痫作用。
[Abstract]:Objective: epileptic (Epilepsy) is a chronic brain disease characterized by transient central nervous system dysfunction caused by abnormal discharges of brain neurons. The quality of life of patients is seriously affected. The pathogenesis of epilepsy is complicated. It has been proved that the neuroendocrine system changes in epileptic patients, and the reason is unknown, which may be related to the peptide hormone ghrelin. Ghrelin is a growth hormone releasing peptide containing 28 amino acids. It is mainly secreted by X-A-like endocrine cells in the gastric fundus and widely distributed in pituitary hypothalamus and other tissues and organs. In order to establish a more convenient and sensitive method for the diagnosis and treatment of epilepsy and the evaluation of therapeutic effect, this paper studies the change characteristics of ghrelin in epileptic patients and preliminarily discusses its expression significance, which provides theoretical basis for further study on the pathogenesis of epilepsy. To provide new ideas for clinical treatment. Methods: forty patients with idiopathic epilepsy were divided into two groups: 18 patients with (Primary generalized seizure, PGE), 7 males and 11 females, aged 2342 years, with the course of 6 months to 30 years, 8 of whom were newly diagnosed. The other 10 patients had been treated with sodium valproate for more than 3 months. There were 22 (Partial seizure, PE) patients (9 males, 13 females) in the partial onset group, aged 24 to 43 years. The course of the disease was 6 months to 30 years, 8 of them were newly diagnosed and were not treated with drugs at the time of entering the group. The remaining 16 patients had been treated with carbamazepine for more than 3 months. 28 healthy persons were selected as normal control group, 12 males and 16 females, aged 25 ~ 43 years. The height, weight and body mass index were measured by standard method. Serum Ghrelin levels were measured by Enzyme-linked immunoadsorbent assay, ELISA) and blood samples were measured simultaneously by enzyme-linked immunosorbent assay (Enzyme-linked immunoadsorbent assay, ELISA). Sugar (Fasting blood glucose, FBG), triglyceride (Triglyceride, TG), total cholesterol (Total cholestero1), high density lipoprotein cholesterol (High-density lipoprotein cholesterol, HDL-c), low density lipoprotein cholesterol (Low-density lipoprotein cholesterol, LDL-c) were collected. The general clinical features included age, sex, body mass index, and compared with the normal control group. Results: 1. The serum Ghrelin concentration was 44.35 卤11.07pg / ml in the idiopathic epilepsy group and 75.37 卤8.52pg / ml in the control group. The serum Ghrelin level in Idiopathic Epilepsy group was significantly lower than that in the control group (P0.05). The serum Ghrel in level in partial seizure group was 50.52 卤9.55pg / ml, which was significantly higher than that in comprehensive seizure group (37.39 卤7.89pg/m1). 3. The concentration of Ghrelin was 39.86 卤6.22pg / ml after treatment with sodium valproate, which was higher than that of untreated group (30.31 卤3.47pg/ml), but still lower than that of control group (P0.05). 4. The concentration of Ghrelin in patients with partial seizure epilepsy was 55.45 卤5.21pg / ml after carbamazepine treatment, which was higher than that in patients without generalized seizure (41.88 卤9.46pg/ml), but still lower than that in control group (P0.05). Conclusion: 1. The serum Ghrelin level of idiopathic epilepsy patients was lower than that of normal patients, and the level of Ghrelin in partial seizure group was higher than that in generalized seizure group, suggesting that Ghrelin might play an important role in epileptic seizures. 2. The level of Ghrelin in the group treated with sodium valproate was higher than that in the group without comprehensive seizure, and the level of Ghrelin in the group treated with carbamazepine was higher than that in the group without partial seizure, suggesting that the high level of Ghrelin might have antiepileptic effect.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742.1

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