癫痫患者血液和脑脊液免疫异常在其发病机制中的作用

The role of immunological abnormalities in blood and cerebrospinal fluid in the pathogenesis of epilepsy

对７２例癫痫患者血液中的ＩｇＧ，ＩｇＡ，ＩｇＭ，Ｃ３，ＣＩＣ、白蛋白、ＣＤ＿４＋细胞、ＣＤ＿８＋细胞和脑脊液（ＣＳＦ）中的ＩｇＧ进行检测，并计算ＣＤ＿４＋／ＣＤ＿８＋比值，ＣＳＦ－ＩｇＧ／Ｓ－ＩｇＧ比率，ＣＳＦ－ＡＬＢ／Ｓ－ＡＬＢ比率有ＩｇＧ指数。结果表明癫痫组血液中的５项参数比对照组低，尤其是原发性和末治疗亚组。而ＣＳＦ却呈现病理性的免疫增强反应，表现为原发性亚组ＩｇＧ指数增高，继发性亚组ＣＳＦ－ＡＬＢ／Ｓ－ＡＬＢ比率增高，说明原发性亚组患者存在内源性ＩｇＧ合成，而继发性亚组患者存在血脑屏障（ＢＢＢ）功能障碍。提示这两种类型的癫痫可能具有不同的发病机制。

IgG,IgA,IgM,C3,CIC,albumin(ALB),CD_4+and CD_8+lymphocytesubsets in blood,and IgG in cerebrospinal fluid(CSF) were determined in 72 epilepticpatients.Furthermore,CD_4+/CD_8+ ratio,CSF-IgG/S-IgG ratio,CSF-ALB/S-ALB ratio,and IgG index were calculated.The results showed that in epileptic patients 5 blood para-meters were significantly lower than that of the control group,especially much lowerin primary and AED-nontreated subgtoups,but there were pathologically elevated immunereactions in CSF,that is,increased IgG index in primary subgroup and increased CSF-ALB/S-ALB ratio in secondary subgroup.These results suggested that there might bedifferent pathogenesis of primary and secondary epilepsies because there were intrathecalsynthesis of IgG in primary subgroup and blood-brain-barrier(BBB)dysfunction in secon-dary subgroup.