抗癫痫药物治疗对癫痫患者血清细胞因子水平的影响

Changes of Serum Cytokins Levels After Drug Therapy in Epileptic Patients

目的 :观察抗癫痫药物治疗前后癫痫患者血清细胞因子水平变化 ,探讨白细胞介素 - 2 (IL - 2 )、白细胞介素 - 6 (IL - 6 )、肿瘤坏死因子 -α(TNF -α)在癫痫神经免疫调节中的作用。方法 :采用放射免疫分析测定 4 3例癫痫患者抗癫痫药物治疗前后 ,血清IL - 2、IL - 6、TNF -α的水平 ,并与年龄和性别相匹配的 32例正常对照组进行比较。结果 :癫痫患者治疗前血清IL - 2、IL - 6、TNF -α水平均显著高于正常对照组 (p <0 0 0 1 ) ,经治疗后有 1 8人疗效显著。其发作次数降低 75 %以上 ,其中有若干病人其血清细胞水平明显降低 ,但总体水平差异呈无显著性 (p >0 0 5 ) ,其余 2 5人疗效较差 ,其水平改变不大 ,但部分反有升高。患者血清IL - 2浓度与IL- 6、TNF -α水平变化呈显著正相关。结论 :癫痫患者血清细胞因子水平增高 ,提示免疫系统处于活化状态 ,但治疗后细胞因子水平改变难以预测 ,即使疗效显著者 ,亦有一些明显降低。

Objective To explore the role of the cytokins interlenkin-2 (IL-2), interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α) in the neuroimmune modulation of epilepsy through measurement of the changes of the sreum levels of the these cytokins after drug therapy in epileptic patients. Methods Serum IL-2, IL-6, TNF-α levels were meusured with RIA in 43 patients with epilepsy both before and after drug therapy for 3-6 months as well as 32 controls. Results Before treatment, serum levels of these cytokins in the patients were significantly higher than those in the controls ( p <0 001)。 After treatment, 18 of the 43 patients were regarded as treatment very successful, with attack numbers decreased more than 75%. Some of this group of patient had their serum cytokins levels significantly dropped down, but the mean level for the group as a whole did not change much. In the rest 25 patients with less successtnl result, changes were not significant with the levels increased in a few cases. Among the cytokins, levels of IL-2 were significantly positively correlated to those of IL-6 and TNF-α ( r=0 47,p<0 01,r=0 55,p<0 01 ). Conclusion Increased levels of the cytokins in the epileptic patients suggest an activated immune state. However, the changes of levels after therapy are not predictable and do not necessarily drop down significantly even with very successful treatment.