热性惊厥患儿血清褪黑素水平和细胞免疫功能的变化及其临床意义

Changes of melatonin and cellular immunological function in children with febrile seizures and its clinical significance

目的探讨热性惊厥（FS）患儿血清褪黑素（MT）水平和细胞免疫功能的变化及其临床意义。方法实验组：FS患儿50例，其中复杂性热性惊厥（CFS组）23例，单纯性热性惊厥（SFS组）27例；对照组：上呼吸道感染发热惠儿25例。采用酶联免疫吸附法（ELISA）和流式细胞仪分别测定实验组和对照组血清MT水平和细胞免疫功能。结果CFS组血清MT水平[（14．91±2．61）ng／L]明显低于SFS组[（20．72±2．54）ng／L]和对照组[（23．93±2．01）ng／L]（P〈0．01）。细胞免疫功能：CFS组CD3＋、CD4＋、CD8＋、CD4＋／CD8＋比值分别为（54．53±3．67）％、（21．95±1．78）％、（33．37±2．84）％、0．664±0．02；SFS组分别为（59．06±3．89）％、（24．80±3．12）％、（26．784-g．79）％、0．94±0．06；对照组分别为（62．11±6．90）％、（27．36±3．94）％、（24．49±2．75）％、1．23±0．15。FS患儿CD3＋、CD4＋、CD4＋／CD8＋比值均降低，CD8＋增加，CFS组与对照组及SFS组间差异均有统计学意义（P〈0．01）；SFS组与对照组比较CD4＋／CD8＋比值降低（P〈0．05），但CD3＋、CD4＋降低和CD8＋增加差异无统计学意义（P〉0．05）。FS患儿CD3＋、CD4＋、CD4＋／CD8＋比值的降低与MT水平的降低均呈正相关（r≥0．472，P〈0．05）。结论FS患儿细胞免疫功能的异常可能与MT减少有关，MT水平降低可能是患儿反复出现·凉厥导致脑损伤的主要原因之一。

Objective To investigate the changes of melatonin and cellular immunological function in children with febrile seizures and its clinical significance. Methods 50 children, including 23 cases with complex febrile seizure （CFS） and 27 cases with simple febrile seizure （SFS） , and 25 cases with upper respiratory infections children selected as control group were enrolled in this study. Serum melatonin was measured by enzyme-linked immunosorbent assay （ELISA） and cellular immunological function was measured by flow cytometer.Results The levels of serum melatonin in the 3 groups of CFS, SFS, control were （ 14. 91 ±2. 61 ） ng/L, （20. 72± 2. 54 ） ng/L, （ 23.93 ± 2. 01 ）ng/L, respectively. The melatonin levels in CFS children were significantly decreased than that in control group and SFS children （ P 〈0. 01 ）. CD3 ＋ ,CD4 ＋ , the ratio of CD4 ＋ /CD8 ＋ and CD8 ＋ in CFS group were significantly decreased than that in control group and SFS group （ P 〈0. 01）. The ratio of CD4 ＋/CD8 ＋ in SFS group was significantly decreased than that in control group （ P 〈0. 05）, but CD3 ＋ ,CIM ＋ and CD8 ＋ had no statistics significance among these groups（ P 〉0. 05）. The serum melatonin level were positive related with decreased degree of CD3 ＋ , CD4 ＋ and the ratio of CD4 ＋ /CD8 ＋ （ r ≥0. 472, P 〈 0. 05 ）. Conclusion The disorder of cellularimmunological function was possible related with the loss of serum melatonin, and the loss of serum melatonin maybe one of the reasons for febrile seizures relapse and brain injured.