癫痫持续状态患者神经元损伤与氧化应激的关系

Relationship between injuries of neuron and oxidative stress in patients with status epilepticus

目的探讨癫痫持续状态(SE)患者神经元损伤与氧化应激的关系。方法以30例SE患者(SE组)为研究对象,检测其在癫痫发作6h内的血清神经元特异性烯醇化酶(NSE)、总超氧化物歧化酶(T-SOD)、8-羟基脱氧鸟苷酸(8-OHdG)及丙二醛(MDA)水平;以30例健康者作为对照组。结果 SE组血清NSE水平(26.98±4.16ng/mL)高于对照组(16.34±3.11ng/mL),T-SOD(77.22±18.42U/mL)低于对照组(104.53±15.99U/mL),8-OHdG(527.36±63.94pg/mL)高于对照组(334.09±57.51pg/mL),MDA(10.58±1.39nmol/mL)高于对照组(5.33±1.76nmol/mL)(P<0.001)。SE组血清NSE水平与T-SOD呈负相关(r=-0.85,P<0.001),与8-OHdG、MDA呈正相关,相关系数分别为0.74和0.86(P<0.001)。多元逐步回归分析显示,T-SOD、8-OHdG、MDA对NSE有显著影响,标准回归系数分别为-0.474、0.055、2.870(P<0.01)。结论 SE患者体内存在氧化系统和抗氧化系统失衡,氧化应激可能参与了癫痫发作的病理生理过程,也是造成SE神经元损伤原因之一。

Objective To investigate the relationship between injuries of neuron and oxidative stress in patients with status epilepticus（SE）.Methods Serum levels of neuron specific enolase（NSE）,total superoxide dismutase（T-SOD）,8-hydroxy-guanine（8-OHdG） and malondialdehyde（MDA）were detected in 30 cases of patients with SE（SE group） within 6 h after epileptic attack.30 cases of healthy subjects were enrolled as control group.Results Serum levels of NSE,8-OHdG and MDA in SE group were 26.98±4.16 ng/mL,527.36±63.94 pg/mL and 10.58±1.39 nmol/mL,which were respectively higher than 16.34±3.11 ng/mL,334.09±57.51 pg/mL and 5.33±1.76 nmol/mL in control group（P0.001）,but T-SOD level（77.22±18.42 U/mL） was lower than control group（104.53±15.99 U/mL）（P0.001）.In SE group,NSE was negatively correlated with T-SOD（r=-0.85,P0.001）,but positively correlated with 8-OHdG and MDA,correlation coefficients of which were 0.74 and 0.86,respectively（P0.001）.Serum levels of T-SOD,8-OHdG and MDA exerted significant effect on NSE,as demonstrated by multivariant stepwise regression analysis（P0.01）.Conclusion Oxidative stress might play a role in epileptic attack and might be an important risk factor in neuron injuries of SE.