神经肽Y在惊厥性疾病患儿血浆和脑脊液中质量浓度变化及临床意义

Neuropeptide Y levels in plasma and cerebrospinal fluid of children with convulsive diseases and its clinical significance.

目的观察血浆、脑脊液中神经肽Y(NPY)的质量浓度变化,探讨NPY在惊厥性疾病中的作用及临床意义。方法选取2002-09—2003-08在陕西省人民医院儿科住院的惊厥性疾病患儿,采用放射免疫分析方法检测血浆和脑脊液中NPY的质量浓度。结果(1)惊厥组血浆中NPY质量浓度第7天较第1天增高,差异有显著性(t=5·366,P<0·01),惊厥组各组第7天与第1天自身比较差异有显著性(t=3·509,3·480,3·379,P<0·05);脑炎无惊厥组第7天较第1天增高,但差异无显著性(t=1·056,P=0·309);惊厥组与脑炎无惊厥组、对照组相比,差异有显著性(t=5·728,P<0·01;t=6·990,P<0·001),脑炎无惊厥组与对照组比较差异无显著性意义(t=0·987,P>0·05),惊厥组各组之间差异也有显著性(F=34·674,P<0·01)。(2)惊厥组脑脊液中NPY质量浓度与脑炎无惊厥组、对照组比较差异有显著性(t=7·830,5·699,P<0·001),脑炎无惊厥组与对照组比较差异无显著性(t=0·112,P=0·911),惊厥组各组之间差异也有显著性(F=68·931,P<0·01)。(3)血浆和脑脊液中NPY质量浓度与惊厥发作次数有关(P<0·05),与性别、年龄、体重无显着相关,P均大于0·05;第1、7天血浆NPY质量浓度与第1天脑脊液NPY质量浓度有显着正相关性(r=0·954,P<0·001;r=0·950,P<0·001)。结论(1)惊厥性疾病患儿血浆、脑脊液中NPY质量浓度均增高,与惊厥发作次数有关,但在惊厥发生的不同阶段质量浓度不同。(2)血浆与脑脊液中NPY质量浓度呈正相关性,血浆中的质量浓度能间接反映脑脊液质量浓度。提示动态监测NPY质量浓度可能有助于对惊厥的临床诊断、治疗及预后的判断。

Objective In order to study the levels and clinical significance of neuropeptide Y（NPY） in plasma and cerebrospinal fluid （ CSF ） in children convulsion. Methods Totally 67 children with convulsive diseases were studied：obtaining the samples of plasma on the 1 st and 7th day after being in hospital, and the samples of CSF on the 1 st after being in hospital. We investigated the changes of NPY in plasma and CSF with radioimmunoassay （ RIA ）. Results （ 1 ） Convulsive group：the concentration of NPY in plasma on the 7th day was higher than that on the 1st day （ P 〈0. 01 ）. Each group in convulsive subjects also had the same result （ P 〈 0. 05 ）. Encephalitis group without convulsion ： The concentration of NPY in plasma on the 7th day was higher than that on the 1st day,but there was no positive difference（ P 〉 0. 05）. The concentration of NPY in plasma on the 1st day in control group was （ 182. 13 ±28. 08 ） ng/L. There were positive differences in convulsive group, encephalitis group without convulsion and control group （ P 〈 0. 01, 0. 001 ）. There was also positive difference in each group in convulsive subjects（ P 〈0. 01 ）. （2） The concentrations of NPY in CSF on the 1 st day were （ 312.66 ± 71.16 ） ng,/L （ convulsive group ）, （ 196.79 ± 23.36 } ng,/L （ encephalitis group without convulsion）, （194. 13 ± 16. 19）ng/L （control group）,respectively. There were positive differences in convulsive group,encephalitis group without convulsion and control group（ P 〈 0. 001 }, but no difference in encephalitis group without con vulsion and control group （ P 〉 0. 05 ）. Each group in convulsive subjects showed positive difference （ P 〈 0.01 ）. The levels of NPY in plasma and CSF correlated to the times of convulsion. （ 3 ） Linear correlation and regression analysis showed：a）the concentrations of NPY in plasma and CSF had no correlation to sex, age, weight （ P 〉 0. 05 ） ; b） the concentrations of NPY in plasma on the 1 st and 7th day had significantly positive correlation to those in CSF on the 1st day （ r =0. 954, P 〈0. 001 ; r =0. 950, P 〈0. 001, respectively）. Conclusion （ 1 ） There are elevated levels of NPY in plasma and CSF in cases with convulsions,changing in the different course of convulsion. （ 2） There is positive correlation in NPY between plasma and CSF. The levels of NPY in plasma can indirectly reflect the levels of NPY in CSF. These findings suggest that the measurement of NPY in children with convulsive diseases cal help to guild the management of convulsive diseases.