癫痫患者血中耐药基因表达产物与抗癫痫药物浓度的关系

Relationship between Drug Resistance Gene Expression Product and Anti-epilepsy Drug Concentration in Epilepsy Patients

目的:了解多药耐受基因(MDR1)表达产物P-糖蛋白(P-GP)与抗癫痫药物(AED)的血药浓度的关系,以探讨癫痫的耐药机制。方法:癫痫患者76例,按气-液层分析法测定的血药浓度分为低于有效血药浓度组(A组)17例、有效血药浓度组(B组)44例、高于有效血药浓度组(C组)15例,用免疫组化的方法测定3组癫痫患者外周血中P-GP表达的阳性率。结果:P-GP阳性,A组5例(29.4%);B组16例(36.4%);C组11例(73.3%)。B组与A组比较P-GP阳性表达率差异无显著性意义,C组与A、B组比较差异有显著性意义(P<0.05)。结论:AED的血药浓度越高,MDR1表达增强,MDR1基因表达增强与抗癫痫药物诱导有关。

Objective： To observe the relationship between the multi-drug resistance gene （MDR1） expression product P-glycoprotein （P-GP） and serum drug concentration in epilepsy patients in order to explore the drug resistance mechanisms. Methods： Patients with epilepsy were divided into three groups according to the drug concentrations measured by gas-liquid analysis： lower effective drug concentration （17 cases, group A）, effective drug concentration （44 cases, group B）, higher effective drug concentration （15 cases, group C）. Immunocytochemistry was used to detect the positive expression rate of P-GP in each group. Results： The positive expression rate of P-GP in groups A, B and C was 29.4%, 36.4% and 73.3% respectively. There was no significant difference in P-GP positive expression rate between group B and group A, but the difference was significant between group C and group A or B （P〈0.05）. Conclusion： With the serum anti-epilepsy drug concentration increasing, the expression of MDR1 was increased. The expression of MDR1 gene was related to the induction of anti-epilepsy drug.