耐药性癫痫患者血清和脑脊液P-糖蛋白的表达水平变化及其临床意义

Expression level change and clinical significance of P-glycoprotein in serum and cerebrospinal fluid in patients with drug-resistant epilepsy

目的观察耐药性癫痫患者血清和脑脊液中多药耐药基因-1、P-糖蛋白的表达水平变化及其临床意义。方法选取2014年1月-2016年4月本院收治的耐药性癫痫患者以及同期在本院接受抗癫痫药物治疗控制良好的癫痫患者各85例,分别作为耐药性癫痫组和治疗有效组。另选取健康人群85例作为健康对照组。采用酶联免疫吸附测定法及荧光定量聚合酶链反应技术检测所有受试人员的外周血清及脑脊液中多药耐药基因-1及P-糖蛋白表达水平,比较不同类型癫痫患者以上两项指标的表达水平变化。结果与治疗有效组、健康对照组比较,难治性癫痫组患者血清P-糖蛋白及MDR1-mRNA表达水平较其他2组均明显增高(P<0.05,P<0.01);治疗有效组与健康对照组比较,血清P-糖蛋白及MDR1-mRNA表达水平无明显差异(P>0.05)。与治疗有效组比较,耐药性癫痫组脑脊液P-糖蛋白及MDR1-mRNA表达水平明显增高(P<0.05)。耐药性癫痫组中不同发作类型患者血清MDR1-mRNA、P-糖蛋白表达水平比较,均无明显差异(P均>0.05)。结论外周血及脑脊液中多药耐药基因-1、P-糖蛋白的表达水平可以作为癫痫耐药的一项重要指标。

Objective To observe expression level change and clinical significance of P-glycoprotein and multidrug resistance gene-1 in serum and cerebrospinal fluid in patients with drug-resistant epilepsy.MethodsFrom January 2014 to April 2016 in our hospital 85 drug-resistant epilepsy patients（drug-resistant epilepsy group）and 85 well controlled epilepsy patients（effective group）were collected,and 85 normal persons were selected as healthy control group,enzyme-linked immunosorbent assay and fluorescence quantitative polymerase chain reaction technique were used to detect multidrug resistance gene-1 and P-glycoprotein level of the peripheral serum and cerebrospinal fluid of all the participants.Results The serum P-glycoprotein and MDR1-mRNA levels in drug-resistant epilepsy group were significantly higher than those in other two groups,the difference was statistically significant（P〈0.05,P〈0.01）.There were no significant difference in serum Pglycoprotein and MDR1-mRNA levels between effective group and healthy control group（P〈0.05）.Compared with effective group,the P-glycoprotein and MDR1-mRNA levels of CSF in the drug-resistant epilepsy group increased significantly,and the difference was statistically significant（P〈0.05）.There was no significant difference in serum MDR1-mRNA and P-glycoprotein levels among patients with different seizure types in drug-resistant epilepsy group（P〈0.05）.Conclusion The expression levels of multidrug resistance genes-1 and P-glycoproteins in peripheral blood and cerebrospinal fluid could be used to become an important parameter of drug resistance in epilepsy.