癫痫型脑囊虫病患者脑脊液生化指标与认知功能的关系研究  

Study on the clinical relationship between the biochemical indicators in cerebrospinal fluid and cognitive function in patients with epileptic cerebral cysticercosis and patients without epileptic cerebral cysticercosis

作　　者：刘琨[1] 李遵清[1] 马现文[1] 刘军波[1] 高鹏[1] 

机构地区：[1]山东省济宁市精神病防治院,山东济宁272051

出　　处：《中国病原生物学杂志》2016年第9期847-850,共4页Journal of Pathogen Biology

摘　　要：目的检测癫痫型与非癫痫型脑囊虫病患者脑脊液生化指标,探讨生化指标与认知功能的关系,为脑囊虫病的临床诊治提供依据。方法选取2005年1月至2015年12月间在本院诊治的38例癫痫型脑囊虫病患者和49例非癫痫型脑囊虫病患者,检测两组患者脑脊液中谷氨酸(glutamate,GLU),天冬氨酸(aspartame acid,ASP),γ-氨基丁酸(γ-amino butyric acid,GABA)、甘氨酸(glycine,GLY)、亮氨酸脑啡肽(leu-enkephalin,L-ENK)、以及一氧化氮(nitric oxide,NO)的含量,并采用简易智能精神状态检查量表(mini-mental state examination,MMSE)测评两组的认知功能,分析生化指标对认知功能的影响。结果癫痫型脑囊虫病患者脑脊液中GLU、L-ENK、GABA、NO含量分别为(404.62±21.38)pmol/ml、(498.53±216.42)ng/L、(134.59±12.46)pmol/ml、(25.16±3.82)μmol/L和(16.43±5.38)pmol/ml,非癫痫型脑囊虫病患者分别为(383.53±23.16)pmol/ml、(243.62±104.37)ng/L、(248.38±16.37)pmol/ml、(20.25±2.57)μmol/L和(25.31±7.05)pmol/ml,差异均有统计学意义(P<0.01);癫痫型脑囊虫病患者和非癫痫型脑囊虫病患者的MMSE评分差异有统计学意义(P<0.01)。Personal相关分析显示,脑脊液生化指标与认知功能呈高度相关性(P<0.01);多元逐步回归分析显示,GABA、GIY、GLU、NO、L-ENK可共同解释癫痫35.61%的变异量。结论癫痫型与非癫痫型脑囊虫病患者脑脊液生化指标以及认知功能具有差异性,GABA、GIY、GLU、NO、L-ENK是癫痫的预测因子,并与认知功能具有相关性,临床医师可根据脑脊液生化指标的变化对脑囊虫病进行诊治,以便更好地防治癫痫,改善患者的认知功能。Objective To measure biochemical indicators in the cerebrospinal fluid（CSF）in order to explore the relationship between levels of biochemical indicators in the CSF and cognitive function in patients with epileptic cerebral cysticercosis and patients without epileptic cerebral cysticercosis in order to facilitate the clinical diagnosis and treatment of cerebral cysticercosis. Methods Subjects were 38 patients with epileptic cerebral cysticercosis and 49 patients without epileptic cerebral cysticercosis who were treated at this Hospital from January 2005 to December 2015.The levels of glutamate（GLU）,aspartame acid（ASP）,γ-amino butyric acid（GABA）,glycine（GLY）,leu-enkephalin（L-ENK）,and nitric oxide（NO）in the CSF were measured in the two groups.Cognitive function of the two groups was evaluated using the MMSE,and the effects of biochemical indicators on cognitive function were analyzed. Results The level of GLU in the CSF of patients with epileptic cerebral cysticercosis was 404.62±21.38pmol/ml,the level of ASP was 498.53±216.42ng/L,the level of LENK was 134.59±12.46pmol/ml,the level of GABA was 25.16±3.82μmol/L,and the level of NO was 16.43±5.38pmol/ml.The level of GLU in the CSF of patients without epileptic cerebral cysticercosis was 383.53±23.16pmol/ml,the level of ASP was 243.62±104.37ng/L,the level of LENK was 248.38±16.37pmol/ml,the level of GABA was 20.25±2.57μmol/L,and the level of NO was 25.31±7.05pmol/ml.The levels of GLU,ASP,LENK,GABA,and NO differed significantly in the two groups（P〈0.01）.The scores on the MMSE of patients with epileptic cerebral cysticercosis and patients without epileptic cerebral cysticercosis differed significantly（P〈0.01）.Correlation analysis indicated that there was a close correlation between biochemical indicators in the CSF and cognitive function（P〈0.01）,Multiple stepwise regression analysis indicated that GABA,GIY,GLU,NO,and LENK together explained 35.61% of the variability of epilepsy. Conclusion Biochemical indicators

关 键 词：脑囊虫病 脑脊液 癫痫 生化指标 认知功能 

分 类 号：R532.33[医药卫生—内科学]