惊厥患儿血β-内啡肽和神经元特异性烯醇化酶变化的意义

Changes of β-Endorphin and Neuron-Specific Enolase Levels in Children with Convulsion and Their Clinical Significances

目的探讨惊厥患儿血β-内啡肽(β-EP)和神经元特异性烯醇化酶(NSE)水平变化的意义。方法选择惊厥患儿(惊厥组)62例,根据病因不同,分为病毒性脑炎(VE,16例)、癫(EP,22例)、热性惊厥(FC,24例)3组。依据病情分为严重组29例,普通组33例。健康对照组20例。采用放射免疫法测定各组血浆β-EP水平,采用酶联免疫法测定其血清NSE水平。结果1.惊厥各组惊厥发作24h内血浆β-EP和血清NSE水平均显著高于健康对照组(Pa<0.01)。但3组不同病因之间比较无显著性差异(Pa>0.05)。2.普通与严重组惊厥发作24h内血液β-EP和NSE水平均显著高于健康对照组(Pa<0.01)。严重组β-EP和NSE水平显著高于普通组(Pa<0.01)。惊厥发作次数越多,持续时间越长,惊厥程度越重,β-EP和NSE水平越高。3.惊厥患儿急性期血β-EP与NSE呈显著正相关(r=0.86P<0.01)。结论惊厥发作后血液β-EP和NSE水平与脑损伤严重程度密切相关,可作为早期判断惊厥性脑损伤的客观指标之一。

Objective To explore the changes of β- endorphin （ β- EP） and neuron - specific enolase （NSE） levels in children with convulsion and their clinical significances . Methods Sixty - two children with convulsion were served as convulsion group, and 20 healthy children were served as normal control group. The blood samples were collected within the first 24 h after seizure. The level of β- EP was measured by radioimmunoassay. The level of NSE was measured by enzyme - linked immunosorbent assay. Results 1. The levels of blood β-EP and NSE in children with convulsion groups （including viral encephalitis, epilepsy and febrile convulsion group）were significantly higher than those in normal control group（Pa 〈 0.01 ）. There were no significant differences among viral encephalitis, epilepsy and febrile convulsion groups（ Pa 〉 0.05 ）. 2. The levels of blood β- EP and NSE in children with convulsion group （including common group and serious group） were significantly higher than those in normal control group（ Pa 〈0.01 ）. The levels of β- EP and NSE in children with serious convulsion were significantly higher than those in normal control group（Pa 〈 0.01 ）. The more times the seizure, the longer lasting time, the more severe the seizure, and the higher levels of β- EP and NSE. 3. β- EP was positively correlated with NSE in children with convulsion at acute stage（r = 0. 86 P 〈 0.01 ）. Condusions The levels of blood β- EP and NSE in children with convulsion are significantly higher after seizure,which has a close correlation with the severity of brain injury, and they may serve as objective indicators in the early prediction of the degree of brain injury.