婴儿痉挛症与相关激素表达水平的关系

Relationship between occurrence of infantile spasms and expression levels of related hormones

目的研究褪黑素(melatonin,MT)、5-羟色胺(5-hydroxytryptamine,5-HT)、催乳素(prolactin,PRL)及一氧化氮(NO)在婴儿痉挛症患儿血清中的浓度,探讨其与婴儿痉挛症发病的相关性。方法选取解放军总医院第一医学中心2017年3-9月住院的婴儿痉挛症患儿39例,同一时期无神经系统疾病尤其是癫痫病史的呼吸道或泌尿系感染患儿42例作为对照。采用酶联免疫法(ELISA法)检测各组血清中的MT、5-HT、PRL及NO水平,比较病例组促皮质素(adrenocorticotropic hormone,ACTH)治疗前后上述激素水平的变化。结果病例组血清MT(pg/ml)(7.1±1.9 vs 11.2±1.8)、5-HT(mIU/L)(1 183.3±258.9 vs 1 488.2±241.6)水平相比照组明显降低(P <0.05),而PRL(mIU/L)(523.1±109.4 vs 358.0±80.7)及NO(μmol/L)(101.3±22.1 vs 72.9±20.8)相比对照组明显增高(P <0.05)。病例组在ACTH治疗后MT(pg/ml)(9.2±1.9)及5-HT(mIU/L)(1 366.0±236.9)较治疗前升高(P <0.05);PRL(mIU/L)(408.2±93.4)较治疗前降低(P <0.05);NOμmol/L(96.3±21.9)较治疗前无统计学差异(P=0.261)。结论婴儿痉挛症患儿MT、5-HT水平降低,而PRL及NO水平升高;ACTH治疗后MT、5-HT水平回升,PRL水平回落。推测MT等激素水平的异常以及互相作用,在婴儿痉挛症发病过程中可能起到重要作用。

Objective To study the serum concentrations of melatonin(MT),5-hydroxytryptamine(5-HT),prolactin(PRL)and nitric oxide(NO)in cases with infant spasms(IS),and explore their correlations with occurrence of IS.Methods Thirty-nine infants with IS were recruited from our department from March to September in 2017,and another 42 infants with respiratory or urinary tract infections who had no history of neurological diseases,especially epilepsy,were recruited as controls.The serum level of MT,5-HT,PRL and NO were measured by the enzyme linked immunosorbent assay(ELISA).And their expression levels in IS group before and after ACTH treatment were compared.Results The serum concentrations of MT and 5-HT in the IS group were significantly lower than those in the control group[(7.1±1.9)pg/ml vs(11.2±1.8)pg/ml;(1 183.3±258.9)mIU/L vs(1 488.2±241.6)mIU/L;P<0.05,respectively],but the serum concentrations of PRL and NO were significantly higher than those in the control group((523.1±109.4)mIU/L vs(358.0±80.7)mIU/L;(101.3±22.1)μmol/L vs(72.9±20.8)μmol/L;P<0.05,respectively)The serum concentrations of MT[(9.2±1.9)pg/ml]and 5-HT[(1 366.0±236.9)pg/ml]in the IS group elevated significantly after ACTH treatment(P<0.05,respectively).However,the serum concentrations of PRL[(408.2±93.4)mIU/L]obviously decreased after ACTH treatment(P<0.01).There was no significant change in the serum concentration of NO(96.3±21.9)μmol/L after ACTH treatment(P=0.261).Conclusion Compared with the control group,the serum levels of MT and 5-HT are significantly lower in the IS group,while PRL and NO levels elevate significantly.After ACTH treatment,the serum levels of MT and 5-HT increase,while PRL level decrease and NO level doesn’t change.Therefore,it is speculated that the abnormal levels of melatonin and its related hormones may play important roles in the pathogenesis of infantile spasms.