免疫球蛋白治疗儿童难治性癫痫的近、远期疗效与体液免疫功能的研究

The study of humoral immunity function and the short- and long-term effective of immunoglobulin treatment in intractable childhood epilepsy

目的 :探讨人血免疫球蛋白治疗儿童难治性癫痫的近、远期疗效和体液免疫功能的变化。方法 :对 36例儿童难治性癫痫辅加人血免疫球蛋白治疗 ,随访 6个月～ 1年 ,分别采用ELISA法和速率散射浊度法对 36例病儿和 2 2例健康儿童进行Ig、C3、C4CH5 0的检测 ,并给予治疗前后配对比较。结果 :36例病儿经辅加免疫球蛋白治疗后 17例终止发作 ,5例显效 ,6例有效 ,8例无效 ,近期总有效率为 77 8%。随访≥ 1年者 2 8例 (77 8% ) ,其中 13例 (4 6 4 % )复发 ,远期有效率为 5 3 6 % ,临床显效时间在用药后 1周内 ,EEG也出现同步显著改善。体液免疫的结果是治疗前癫痫组Ig中的IgG、IgM和C3、C4、CH5 0明显低于对照组 (P <0 0 1) ;治疗后癫痫患儿IgG、IgM和C3、C4、CH5 0明显高于治疗前 (P <0 0 1) ,特别是C3、C4、CH5 0升高最为明显。半年后复检Ig和C3、C4、CH5 0又降低 ,配对比较差异有显著性 (P <0 0 1)。结论 :癫痫患儿体液免疫功能明显低下 ,给予人血免疫球蛋白后 77 8%病例近期临床发作得到控制 ,EEG转为正常或好转 ,也可使血IgG、IgM和C3、C4、CH5 0含量短期内升高 ,这可能是人血免疫球蛋白能有效治疗癫痫的机制之一。

Objective:To explore the short and long term effective and the changes of the immunoglobulin and complements after immunoglobulins therapy in intractable childhood epilepsy.Methods:To observe the clinical efficacy of 6 month～1 year in 36 cases with intractable epilepsy was treated added immunoglobulins and to detect the immunoglobulins and complements 3、4、CH50 which were measured by using ELISA and nephelometry method in them and 22 healthy children were control group and to comparing the changers among them in match before and after treatment.Results:The result showed that the efficacy was 17 cases to be ceased entirely,in 5 cases the attacks markedly improved, the other 6 cases improvement too,and remained 8 cases unchanged, the total effective rate of short term was 77 8%,28 cases following over one years, of them 13(46 4%)attacks repeated, the long term effective rate was 53 6%.The present time of clinical efficacy was in a week,EEG improvement at same time.The results of humoral immunity Ig and C3,C4,CH50 were lower in epilepsy group than in control group (P<0 01) befroe immuoglobulin treatment;The levels of Ig and C3、C4、CH50 were higher than that of the control group (P<0 01) after immuoglobulin treatment.It was IgG、IgM and C3、C4、CH50 that the levels of them were prominent higher.After half or a year measured again,the levels of Ig and C3、C4、CH50 were lower.There were a significant difference before and after immunoglobulins treatment to comparing with each other.Conclusion:The humoral immunity function showed significant decrease in intractable childhood epilepsy.There were 77 8% cases with intractable epilepsy which attacks were controlled after added immunoglobulins treatment.The EEG was not only improved,but it may be became normality.The levels of Ig and C3、C4、CH50 were also enhanced in short time.It was considered wihich the state of humoral immunity function weas play an important role in therapy the children with intractable epilepsy. [