癫患儿血清及脑脊液神经元特异性烯醇化酶和肿瘤坏死因子-α测定的意义  

Expressions of Neuron-Specific Enolase and Tumor Necrosis Factor-α Concentrations of Serum and Cerebrospinal Fluid in Children with Epilepsy and Its Significances

作　　者：李伟[1] 李光乾[1] 林忠东[1] 焦颖[1] 金胜鑫[2] 

机构地区：[1]温州医学院附属育英儿童医院小儿神经内科,浙江温州325027 [2]温州医学院附属育英儿童医院检验科,浙江温州325027

出　　处：《实用儿科临床杂志》2007年第8期611-612,635,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨癫(EP)患儿血清和脑脊液(CSF)神经元特异性烯醇化酶(NSE)和肿瘤坏死因子-α(TNF-α)的表达及其与脑损伤的关系。方法EP患儿62例,分为严重组28例(首次采集标本前24 h内发作≥3次和(或)单次发作时间≥15 min),轻症组34例(24 h内发作<3次及单次发作时间<15 min)。采用电化学发光法测定62例EP患儿惊厥发作后24 h内和30例对照组血清和CSF中NSE水平;采用放射免疫法测定其血清NSE和CSF中TNF-α水平。结果EP严重组、轻症组和对照组血清和CSF中NSE、TNF-α经方差分析均有显著性差异(Pa<0.01)。严重组血清和CSF中NSE、TNF-α明显高于轻症组(P<0.01,0.05)。二组血清和CSF中NSE、TNF-α与对照组比较,均有显著性差异(Pa<0.01)。NSE血清和CSF水平有相关性[r(重)=0.579,r(轻)=0.55Pa<0.01];TNF-α水平也有相关性[r(重)=0.525,r(轻)=0.488 Pa<0.01]。CSF中NSE、TNF-α水平呈高度正相关[r(重)=0.512,r(轻)=0.454 Pa<0.01]。结论EP患儿血清、CSF中NSE和TNF-α水平明显增高,NSE上升水平与癫发作的频率、持续时间密切有关,能反映癫发作脑损伤的严重程度。TNF-α与NSE相关,参与EP脑损伤的病理过程。Objective To explore the levels of neuron - specific enolase（NSE） and tumor necrosis factor -α（TNF -α） concentrations of serum and cerebrospinal fluid（CSF） in children with epilepsy, and evaluate its relationships with neuronal damage. Methods Sixty - two epi- lepsy children were divided into 2 groups ： severe group including 28 cases of frenquent seizures t≥3 vices or time of master single test seizures t≥ 15 rain, mild group including 34 cases of infrenquent seizures 〈 3 vices or time of master single test seizures time 〈 15 min. The serum and CSF NSE （r=0. 579,severegroup;r=0.550,mild group Pa〈0.05） andTNF-α（r=0.525,severegroup;r=0.488,mildgroup Pa〈0.01） were determined respectively by electrochemiluminescenc and radioimmunoassay in 62 epilepsy children within 24 h after seizures and 30 controis. Results The serum and CSF levels of NSE and TNF-α had significant difference among severe group, mild group and control group through variance analysis（ P. 〈 0.01 ）. The serum and CSF levels of NSE and TNF -α in severe group within 24 hours after seizure were significantly higher than those in mild group （P 〈0.01,0.05）. The levels of NSE and TNF -α in severe group or mild group were significantly higher than those in control group （ P. 〈 0.01 ）. The serum NSE （ r = 0. 579, severe group ; r = 0.55, mild group P. 〈 0.01 ） and TNF -α （ r = 0. 525, severe group ; r = 0. 488, mild group P. 〈 0.01 ） were positively correlated with those of CSF, respectively. The CSF levels of NSE were positively correlated with CSF levels ofTNF -α（r = 0. 512,severe group;r =0.454,mild group Pa 〈0.01 ）. Conclusions The serum and CSF NSE and TNF - ct significantly increase in epilepsy children. Ascendant level of NSE is correlated to frequency and duration of seizure, and can reflect severe degree of brain injury after seizure. TNF -α is positively correlated with NSE, and participate in pathoprocedure of brain injury after seizure.

关 键 词：癫痫 脑损伤 磷酸丙酮酸水合酶 肿瘤坏死因子-Α 电化学发光法 放射免疫测定法 

分 类 号：R742.1[医药卫生—神经病学与精神病学]