婴儿痉挛症的神经生化研究

Neurobiochemical Study in Infantile Spasm

本文对15例婴儿痉挛症患儿在24小时连续监测过程中,隔12小时每例作两次 CSF取样,用高压液相色谱仪和电化学检测器测定三种单胺化物的代谢产物 MHPG,HVA 和5HIAA的数值,结果发现5例呈系列点头发作组同年龄匹配的5例非系列点头发作组以及同年龄匹配的5例非癫痫脑病恢复期患儿之间并无有意义的差别,但从5例呈系列点头发作患儿的第1次和第2次 CSF 取样中的5-HIAA 数值来看则第1次明显高于第2次的测定数值(P<0.02)从而设想5-HIAA 高值可能是1岁以内婴儿痉挛症患儿常见的呈系列点头发作的影响因素。

In an attempt to elucidate the possible role of monoamine metabolites in thepathogenesis of infantile spasms(IS),especially in the build-up of serial noddingattacks,the concentrations of MHPG,HVA and 5HIAA in the lumbar spinal fluid(LSF)were determined,using the method of HPLC with electrochemical detector.In 5 cases of IS with serial nodding attack(group A)the first sample of LSFwas usually withdrawn at 2 to 3 o'clook afternoon,that is to say,approximately 7hours after the serial attacks,which were monitored with round-the-clock EEG,and the second sample taken 12 hours later following the first one,namely,at 2 to3 o'clock midnight.For comparison,5 cases of age-matched IS without serial attacks(group B),5 cases of IS without serial attacks,aged over two(group C),andage-matched non-epileptics(group D),were studied under the same protocol,withthe exception that only one sampling was taken for the non-epileptics.The resultsshowed,among age-matched cases,i.e.cases in group A,B and D,differences in theconcentration of MHPG,HVA or 5HIAA in the CSF could not be found.However,in group A,a statistically significant increase of 5HIAA in the first sample,as com-pared with that in 'the second one was demonstrated.These findings suggestedthat the high turnover of 5HT might potentiate an outburst of nodding attacks,andprovide a reasonable explanation for the preference of serial attacks in the earlymorning as the infant awoke.