脑电图异常与继发性癫痫患者外周血肿瘤坏死因子α水平的关系:可否成为评估指标

Association between abnormal electroencephalogram and levels of tumor necrosis factor-alfa in peripheral blood of patients with secondary epilepsy:Is it a marker for evaluation

目的:探讨脑电图异常与继发性癫痫患者不同时期外周血肿瘤坏死因子α水平变化和癫痫发作次数与程度的关系。方法:症状性癫痫患者40例为沈阳医学院附属第二医院神经内科2003-01/12收治,其中癫痫持续状态患者18例,发作一次患者22例,健康体检者20例为对照组。采用双抗体夹心ABC-ELISA法测定第1次抽搐发作后1,24h血清肿瘤坏死因子α水平。两组患者均于第1次抽搐发作后1,24h做常规脑电图。结果:所有被试者均完成了测试。①脑电图:对照组脑电图均正常。第1次抽搐发作后1h癫痫持续状态患者异常率为83%(15/18),高于一次发作患者[54%(11/22),χ2=4.835,P=0.028]。癫痫持续状态患者发作后24h脑电图异常率为72%(13/18),仍高于一次发作患者[45%(10/22)],但与发作后1h相比无明显变化(χ2=2.903,P=0.088)。②外周血肿瘤坏死因子α:第1次抽搐发作后1h癫痫持续状态患者为(108.50±9.34)ng/L,一次发作患者为(101.41±6.75)ng/L,均明显高于对照组[(55.80±3.86)ng/L,P<0.01],癫痫持续状态患者与一次发作患者相比也明显升高(P=0.011);癫痫持续状态患者发作后24h外周血肿瘤坏死因子α为(105.94±7.78)ng/L,较发作后1h无明显变化(P=0.379),一次发作患者发作后24h[(56.61±2.99)ng/L]与发作后1h相比明显降低(P<0.01),且明显低于癫痫持续状态患者(P<0.01)。结论:症状性癫痫发作次数越多,程度越重,患者外周血肿瘤坏死因子α水平越高,脑电图异常率越高,而且离发作期的时限越近,外周血中肿瘤坏死因子α的水平越高。说明外周血肿瘤坏死因子α水平的变化与脑电图一样可作为评估症状性癫痫患者病情及康复效果的指标。

AIM:To study the association between abnormal electroencephalogram and levels of tumor necrosis factoralfa and times and severity of epileptic seizure in peripheral blood of patients with secondary epilepsy at different time.METHODS:A total of 40 patients with epilepsy were selected from the Department of Neurology,Second Affiliated Hospital of Shenyang Medical College from January to December 2004.Among them 18 cases were continual epilepsy and 22 cases were only once epilepsy,20 healthy persons were selected as control group.The level of tumor necrosis factoralfa was detected by using double antibody filling with ABCEnzymelinked immunoadsordent assay method 1 or 24 hours after first spasm of twitch.Patients of two groups were all checked with routine electroencephalogram 1 and 24 hours after first spasm. RESULTS:All persons finished the test.①The electroencephalogram indicated normal results in control group;the abnormal rate of electroencephalogram in patients with continual epilepsy[83%(15/18)] 1 hour after first spasm was higher than that in patients with once epilepsy[54%(11/22)] (χ2=4.835, P=0.02);the abnormal rate in patients with continual epilepsy[72%(13/18)] 24 hours after the first spasm was higher as compared with that in patients with once epilepsy[45%(10/22)],but there was no significant difference as compared with that at 1 hour after the first spasm(χ2=2.903,P=0.088).②The level of tumor necrosis factoralfa[(108.50±9.34) ng/L] in patients with continual epilepsy increased obviously as compared with that in patients with once epilepsy[(101.41±6.75) ng/L](P=0.011) 1 hour after the first spasm,which increased significantly as compared with that in control group[(55.80±3.86) ng/L,P< 0.01];the level of tumor necrosis factoralfa was(105.94±7.78) ng/L in patients with continual epilepsy 24 hours after first spasm, and there was no significant difference as compared with that at 1 hour(P=0.379);the level of tumor necrosis factoralfa[(56.61±2.99) ng/L] in patients with once epilepsy 24 hours after the first spasm decreased obviously as compared with that that at 1 hour and in patients with continual epilepsy(P< 0.01).CONCLUSION:The level of the tumor necrosis factoralfa and the abnormal rate of electroencephalogram in peripheral blood increase along with the increased severity of epilepsy and the times of epileptic seizure in patients with symptomatic epilepsy.However, the nearer the time of epileptic seizure is,the higher the level of the tumor necrosis factoralfa is.The changes of the tumor necrosis factoralfa in peripheral blood of the epileptic as well as electroencephalogram can serve as a marker for evaluating the state and rehabilitation efficacy of patients with symptomatic epilepsy.