人血免疫球蛋白治疗儿童难治性癫痫的体液免疫功能变化及近、远期疗效观察  

Changes of humoral immunity fuction and the short-and long-term effects after immunoglobulins therapy in intractable childhood epilepsy

作　　者：许继平[1] 李玉莲[1] 孙昭辉[1] 颜惠兰[2] 苗丰莲 

机构地区：[1]山东大学第二医院,山东济南250033 [2]山东大学齐鲁医院 [3]威海市市立医院

出　　处：《山东医药》2003年第19期3-5,共3页Shandong Medical Journal

基　　金：山东省卫生厅资助项目 ( No.2 0 0 1CA1CJA5 )

摘　　要：目的　探讨人血免疫球蛋白治疗儿童难治性癫痫 (EP)的近、远期疗效和体液免疫功能的变化。方法　对 36例难治性 EP患儿辅加人血免疫球蛋白治疗 ,随访 0 .5～ 1年 ,分别采用 EL ISA法和速率散射浊度法对其治疗前后 Ig、C3、C4 和总补体溶血活性 (CH50 )进行检测 ,并进行比较。结果　 1临床疗效 :治疗组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 2 8例 ,其中 13例复发 ,远期总有效率为 5 3.6 % ,临床显效时间在用药后 1周内 ,EEG出现同步显著改善。2体液免疫检测结果 :治疗前治疗组 Ig G、 Ig M和 C3、 C4 、 CH50 明显低于对照组 (P<0 .0 1) ,治疗后均明显高于治疗前 (P<0 .0 1)。结论　难治性 EP患儿体液免疫功能明显低下 ,给予人血免疫球蛋白后 ,77.8%近期临床发作得到控制 ,EEG转为正常或好转 ,Ig G、Ig M和 C3、C4 、CH50 含量升高 ,这可能是人血免疫球蛋白能有效治疗 EP的机制之一。Objective To explore the short and long term effects and the changes of humoral immunity function after immunoglobulins therapy in intractable childhood epilepsy Methods 36 cases with intractable epilepsy were treated by added immunoglobulins and the clinical efficacies of 0 5～1year were observed The immunoglobulins(Ig)and complements 3(C 3),4(C 4),and CH 50 before and after treatment were measured by using Enzyme Linked Immuno Sorbent Assay(ELISA) and nephelometry method,and the differences were compared.Results Among the 36 cases,17 cases ceased entirely,the attacks markedly improved in 5 cases, the other 6 cases improved too, and only 8 cases unchanged The total effective rate of short term was 77 8% Follow up of 1 year was made in 28 cases and attacks repeated in 13 cases(46 4%)among them.The long term effective rate was 53 6% The present time of clinical efficacy was in a week and the improvement of EEG was at the same time Ig,C 3, C 4 and CH 50 in the therapic group were lower than in the control group before treatment (P<0 01) and above indexes in therapic group after treament were higher than before treatment Conclusion Humoral immunity function decreases significantly in intractable childhood epilepsy There were 77 8% cases with intractable epilepsy whose attacks controlled by added immunoglobulins treatment The EEG improved and may become normal The serum levels of IgG,IgM and C 3,C 4,CH 50 were also enhanced in short time It was considered that the state of humoral immunity function played a important role in the therapy of the intractable childhood epilepsy

关 键 词：难治性癫痫 人血免疫球蛋白 治疗 儿童 体液免疫功能 疗效 ELISA法 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R977.6[医药卫生—临床医学]