药物控制良好与不良的癫痫大发作患者脑内神经递质活动的超慢涨落图特征

Encephalofluctuographic Features of Neurotransmitter Activation in Epileptic Patients with Good Control or Poor Control

目的探讨控制良好与不良的癫痫大发作患者脑内神经递质活动的变化及差异。方法用WF92型脑电超慢涨落分析仪,检测药物控制良好、药物控制不良的癫痫大发作患者及正常人的脑电超慢涨落图(ET),通过分析其谱线变化来反映脑内神经递质活动的变化。结果与正常人(n=20)比较,药物控制不良组(n=20)神经递质谱系S1显著降低,S2显著增高,S5有增高趋势。而药物控制良好组S1略降低,S2略增高,但均无统计学差异;S3、S4、S7和S11三组均无明显差异。提示癫痫大发作患者脑内存在以S1γ-氨基丁酸(GABA)和S2谷氨酸(G lu)为主的多种神经递质谱系活动的异常,并与癫痫活动性相关。S3乙酰胆碱受体(Ach-R)、S4 5-羟色氨(5-HT)、S7去甲肾上腺素(NE)和S11多巴胺(DA)活动无明显变化。结论癫痫控制良好者脑内神经递质活动基本正常,而控制不良者存在以GABA和G lu为主的多种递质活动异常。因此ET可能成为判断癫痫活动性的有效方法。

Objective To explore neurotransmitter activation in epileptic patients with good control and poor control. Methods Encephalo-fluetuograms（EFG） were obtained from 20 epileptic patients with good control, 20 patients with poor control and 20 healthy individuals. Parameters of EFG that reflect neurotransmitter activation were analyzed. Results Compared with healthy individuals＇ neurotransmitter list in EFG, S1 was significantly lowered and S2 significantly increased ; S5 was also elevated a little , with having no significance in epileptic patients with poor control. On the contrary, S1 and $2 changed the same way as described above but having no statistic differences in epileptic patients with good control. Changes of S3, S4,S7, S11 had no significance in all groups studied. Conclusions Patients with good control have comparably normal neurotransmitter activation, while patients with poor control have obviously abnormal neurotransmitter activation, mainly GABA （S1） and Glu （S2） ; Therefore ET may be a useful means to value the prognosis of epilepsy.