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。
Objectives To investigate the changes of serum monoamine neurotransmitters and myocardial enzymes in patients with refractory epilepsy（RE）, and the possible effects on the cardiovascular system, which would contribute to provide help and guidance to the early warming and prevention to the sudden unexpected death in epilepsy（SUDEP）. Methods We collected sixty patients with RE who admitted to Neurological department of First Hospital of Jilin University from December 2015 to December 2016. According to the exclusion criteria, we selected thirty-two patients into the study. The study included 21 males and 11 females patients. Epinephrine（EPI）, norepinephrine（NE）,dopamine（DA）, 5-hydroxytryptamine（5-HT）, creatine kinase isoenzyme（CKMB）, lactate dehydrogenase（LDH） and hydroxybutyrate dehydrogenase（HBDH） were measured in peri-ictal period and the interictal period in the patients. All the data were analyzed by SPSS17.0 statistical software. Results（1） Thirty two patients were eligiblefor this study and the maleto female ratio is 21：11; The age ranged from 15 to 85 years old, with the average age of 50.9±17.6 years old. Twelve（37.5%） were older than 60 years old and 20（62.5%） were under 60 years old. The epilepsy history ranged from 1 year to14 years, with an average of 3.75±3.12 years;（2） Comparing the levels of monoamine neurotransmitters in peri-ictal period and the interictal period in the patients with RE, we found that the level of EPI and LDH was significantly lower than that in interictal period, while the levels of NE and DA were significantly increased;（3） The results showed that EPI,NE and DA levels in patients under 60 were higher than over 60;（4） Patients were divided into four groups according to the etiology of the disease： idiopathic epilepsy group（10 cases, 31.25%）, post-encephalitic epilepsy group（7 cases, 21.88%）,post-stroke epilepsy group（9 cases, 28.12%） and epilepsy after brain injury group（6 cases, 18.75%）. The result
出处
《癫痫杂志》
2018年第1期1-5,共5页
Journal of Epilepsy
基金
国家自然科学基金(81571264)
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
Refractory epilepsy
Monoamine neurotransmitters
Myocardial enzyme
Peri-ictal period
Sudden unexpected death in epilepsy
