乙拉西坦对癫痫患者血清HMGB1 GFAP水平的影响  

Effect of levetiracetam on serum HMGB1,GFAP levels in epilepsy patients

作　　者：刘文静[1] 刘博[1] 王夏红[1] LIU Wenjing;LIU Bo;WANG Xiahong(Zhengzhou Second People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第二人民医院,河南郑州450000

出　　处：《中国实用神经疾病杂志》2020年第18期1596-1601,共6页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关项目(编号:201503232)。

摘　　要：目的研究左乙拉西坦对癫痫患者血清高迁移率组蛋白1(HMGB1)和神经胶质酸性蛋白(GFAP)水平的影响。方法选择于2019-02—2020-06郑州市第二人民医院收治的癫痫患者50例,随机分为对照组和观察组,各25例,对照组给予丙戊酸钠治疗,剂量从5~10 mg/(kg·d)增至20~30 mg/(kg·d),并维持该剂量;观察组在对照组基础上给予左乙拉西坦治疗,剂量从10 mg/(kg·d)增至20~40 mg/(kg·d),维持该剂量,2组患者均治疗6个月。评价患者临床疗效、检测患者认知状态相关参数、血清中细胞因子、GFAP和HMGB1水平,观察患者治疗期间不良反应发生情况。结果对照组总有效率为68%低于观察组的96%,差异具有统计学意义(P<0.05)。治疗后观察组患者认知状态相关参数脑源性神经营养因子(BDNF)水平升高,髓鞘碱性蛋白(MBP)水平降低,均优于对照组,差异有统计学意义(P<0.05);治疗后2组患者血清中淋巴因子(白细胞介素(IL)-2、IL-4和IL-10)均降低,且观察组低于对照组,差异均具有统计学意义(P<0.05);治疗后,2组患者血清中单核因子(肿瘤坏死因子(TNF-α)、IL-6和IL-8)水平均降低,且观察组水平低于对照组(P<0.05);治疗后,2组患者血清中HMGB1、GFAP水平均降低,且观察组降低更多,差异具有统计学意义(P<0.05);对照组不良反应发生率为12.00%,观察组为8.00%,差异无统计学意义(P>0.05)。结论左乙拉西坦治疗癫痫患者可提高临床疗效,改善患者认知状态,控制细胞因子水平,降低患者血清中HMGB1、GFAP水平,且不良反应低。Objective To study the effect of levetiracetam on serum high mobility histone 1(HMGB1)and glial fibrillary acidic protein(GFAP)levels in epilepsy patients.Methods Fifty patients with epilepsy who were admitted to Zhengzhou Second People’s Hospital from February 2019 to June 2020 were randomly divided into a control group and an observation group,each with 25 cases.The control group was given sodium valproate at a dose of 5-10 mg/(kg·d)increased to 20-30 mg/(kg·d)and maintained at this dose;the observation group was given levetiracetam on the basis of the control group,and the dose increased from 10 mg/(kg·d)to 20-40 mg/(kg·d).Maintain this dose.Patients in both groups were treated for 6 months.Evaluate the clinical efficacy of patients,detect the relevant parameters of the patient’s cognitive status,serum cytokines,GFAP and HMGB1 levels,and observe the occurrence of adverse reactions during the treatment of the patients.Results The total effective rate of the control group was 68%lower than that of the observation group 96%,and the difference was statistically significant(P<0.05).After treatment,the level of brain-derived neurotrophic factor(BDNF),and the level of myelin basic protein(MBP),which are related to the cognitive status of patients in the observation group,were higher than those of the control group.The difference was statistically significant(P<0.05);After treatment,serum lymphokines(interleukin(IL)-2,IL-4 and IL-10)in the two groups of patients were reduced,and the observation group was lower than the control group,the difference was statistically significant(P<0.05)After treatment,the serum levels of mononuclear factors(tumor necrosis factor(TNF-α),IL-6 and IL-8)in the two groups of patients decreased,and the level of the observation group was lower than that of the control group(P<0.05);after treatment The levels of HMGB1 and GFAP in the serum of the two groups of patients decreased,and the observation group decreased more,the difference was statistically significant(P<0.05);the adverse re

关 键 词：左乙拉西坦 癫痫 认知状态 细胞因子 高迁移率组蛋白1 神经胶质酸性蛋白 

分 类 号：R742.1[医药卫生—神经病学与精神病学]