癫痫患者脑脊液中P糖蛋白和多巴胺水平变化及其临床意义

Changes of P-glycoprotein and dopamine levels in cerebrospinal fluid of patients with epilepsy and their clinical significance

目的研究癫痫患者脑脊液中P糖蛋白和多巴胺水平变化及其临床意义。方法将海南医学院第一附属医院2013年12月至2016年8月收治的癫痫患者78例纳入观察组,另将同期于该院体检的无癫痫、无精神疾病和认知功能障碍的80例健康者纳入对照组,比较观察组和对照组、难治性癫痫和非难治性癫痫患者以及不同预后患者脑脊液中P糖蛋白和多巴胺水平。采用受试者操作特征曲线(receiver operator characteristic curve,ROC曲线)分析脑脊液中P糖蛋白和多巴胺水平评估癫痫患者预后的临床价值。结果观察组患者脑脊液中P糖蛋白和多巴胺水平均显著高于对照组(均P<0.05)。难治性癫痫患者脑脊液中多巴胺和P糖蛋白水平均显著高于非难治性癫痫患者(均P<0.05)。难治性癫痫患者预后良好12例,预后不良23例;非难治性癫痫患者预后良好33例,预后不良10例。难治性和非难治性癫痫预后良好患者脑脊液中P糖蛋白和多巴胺水平均显著低于预后不良患者(均P<0.05)。ROC曲线分析显示:脑脊液中多巴胺和P糖蛋白水平评估癫痫患者预后的灵敏度分别为95.6%和88.9%,特异度分别为87.9%和84.8%。结论癫痫患者脑脊液中P糖蛋白和多巴胺水平随着疾病进展而升高,且与患者预后有关。

Objective To study the changes of P-glycoprotein and dopamine levels in cerebrospinal fluid of patients with epilepsy and their clinical significance.Method A total of 78 patients with epilepsy admitted to the First Affiliated Hospital of Hainan Medical University from December 2013 to August 2016 were included in observation group,and 80 healthy people without epilepsy,mental illness and cognitive impairment who had examination during the same period in that hospital were included in control group.The levels of P-glycoprotein and dopamine in cerebrospinal fluid of patients in observation group and control group,refractory epilepsy and non-refractory epilepsy and patients with different prognosis were compared.The clinical value of analyzing P-glycoprotein and dopamine levels in cerebrospinal fluid by receiver operator characteristic curve(ROC curve)to evaluate the prognosis of epilepsy patients.Result The levels of P-glycoprotein and dopamine in cerebrospinal fluid of observation group were significantly higher than those of control group(all P<0.05).The levels of dopamine and P-glycoprotein in cerebrospinal fluid in patients with refractory epilepsy was significantly higher than that in patients with non-refractory epilepsy(all P<0.05).12 patients with refractory epilepsy had good prognosis and 23 patients had poor prognosis;33 patients with non-refractory epilepsy had good prognosis and 10 patients had poor prognosis.The levels of P-glycoprotein and dopamine in cerebrospinal fluid of patients with refractory and non-refractory epilepsy with good prognosis were significantly lower than those with poor prognosis(all P<0.05).ROC curve analysis showed that the sensitivity of cerebrospinal fluid dopamine and P-glycoprotein levels in evaluating the prognosis of epilepsy patients were 95.6%and 88.9%,and the specificity were 87.9%and 84.8%,respectively.Conclusion The levels of cerebrospinal fluid P-glycoprotein and dopamine in patients with epilepsy increase with the progression of the disease,and are related to the patient's prognosis.