本文關(guān)鍵詞： 癲癇 體液免疫 GADA ANA　出處：《大連醫(yī)科大學(xué)》2014年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的：觀察成人癲癇患者外周血中谷氨酸脫羧酶抗體（Anti glutamic aciddecarboxylase antibodies，GADA）、抗核抗體（Anti nuclear antibody，ANA）的水平，分析上述2種自身抗體與成人癲癇發(fā)病機(jī)制的相關(guān)性，探討體液免疫異常對(duì)成人癲癇患者的影響及可能的病理生理機(jī)制，，以期防治癲癇提供新的途徑。 方法：隨機(jī)選擇成人癲癇患者30例為病例組，同期健康體檢者30例為正常對(duì)照組，符合入組標(biāo)準(zhǔn)，除外排除標(biāo)準(zhǔn)，組間年齡與性別的構(gòu)成、伴發(fā)可疑自身免疫性疾病家族史的情況可比。主要方法為對(duì)照研究，根據(jù)病因?qū)⒉±M初步分為隱源性癲癇組（19例）和癥狀性癲癇組（11例），組間及組內(nèi)的年齡、性別構(gòu)成、發(fā)作頻率及伴發(fā)自身免疫性疾病方面具有可比性。分別記錄患者的性別、年齡、發(fā)病年齡、病程、臨床發(fā)作類(lèi)型、發(fā)作頻率、既往病史、空腹血糖、頭部MRI檢查等一般情況。所有入組的癲癇患者于入院次日清晨采集空腹外周血后送檢，應(yīng)用酶聯(lián)免疫吸附法測(cè)試外周血GADA及ANA水平。所得結(jié)果采用SPSS20.0統(tǒng)計(jì)軟件分析，對(duì)各變量采用正態(tài)性檢驗(yàn)，兩組間定量資料比較，符合正態(tài)分布者采用t檢驗(yàn)；不符合正態(tài)分布者，采用Kruskal-Wallis檢測(cè)方法。樣本率的比較采用χ2檢驗(yàn)，當(dāng)n40或T1時(shí)即采用確切概率法。對(duì)于兩組間的定量資料相關(guān)性分析采用Spearman等級(jí)相關(guān)性分析。比較分析應(yīng)用兩樣本均數(shù)的t檢驗(yàn)、配對(duì)t檢驗(yàn)及方差分析。對(duì)于分類(lèi)變量采用卡方檢驗(yàn)，完成組間差異檢驗(yàn)。檢驗(yàn)的顯著性水準(zhǔn)為雙側(cè)檢驗(yàn)P0.05。 結(jié)果： 1、成人癲癇患者中，隱源性、癥狀性癲癇組血清GADA的陽(yáng)性率（17.6%，10%）較正常對(duì)照組顯著升高（P=0.0170.05，P=0.0200.05），隱源性癲癇組的GADA陽(yáng)性率較癥狀性癲癇組明顯升高（χ2=0.556，P=0.0240.05），有統(tǒng)計(jì)學(xué)意義。癥狀性癲癇組血清GADA陽(yáng)性率與病程正性相關(guān)（r=0.398，P=0.040.05）。隱源性癲癇組血清GADA陽(yáng)性率與空腹血糖異常顯著正相關(guān)（r=0.549，P=0.0030.01）。 2、成人癲癇患者中，隱源性、癥狀性癲癇組血清ANA陽(yáng)性率（35.3%，9.1%）較正常對(duì)照組顯著升高（P=0.0160.05，P=0.0320.05），隱源性癲癇組的ANA陽(yáng)性率較癥狀性癲癇組明顯升高（χ2=0.151，P=0.0300.05），有統(tǒng)計(jì)學(xué)意義。兩組血清中ANA陽(yáng)性率與病程正性相關(guān)（r=0.109，P=0.0230.05；r=0.071，P=0.0180.05），而成人癲癇患者的ANA陽(yáng)性率與血糖異常無(wú)顯著相關(guān)。 3、成人癲癇患者血清GADA與ANA陽(yáng)性率具有顯著相關(guān)性（χ2=18.987，0.01）。 結(jié)論： 1、部分成人癲癇患者體內(nèi)存在體液免疫異常。 2、成人隱源性癲癇患者的體液免疫異常較癥狀性癲癇多見(jiàn)。 3、GADA與ANA可能協(xié)同參與并影響癲癇的病理過(guò)程。
[Abstract]:Objective: to observe the levels of anti glutamic aciddecarboxylase antibodiesgardine, anti nuclear antibody Anti nuclear antibody Ana in peripheral blood of adult epileptic patients, and to analyze the correlation between the above two autoantibodies and the pathogenesis of adult epilepsy. To explore the effect of abnormal humoral immunity on adult epileptic patients and its possible pathophysiological mechanism in order to provide a new approach for the prevention and treatment of epilepsy. Methods: 30 adult epileptic patients were randomly selected as the case group and 30 healthy persons as the normal control group, which were in accordance with the criteria of admission, excluding the exclusion criteria, and the composition of age and sex between groups. The family history of suspected autoimmune diseases was compared. The main method was a control study. According to the etiology, the patients were divided into cryptogenic epilepsy group (n = 19) and symptomatic epilepsy group (n = 11). Sex, age, age, course of disease, type of clinical attack, frequency of attack, history of illness, fasting blood glucose were recorded. GADA and ANA levels in peripheral blood were measured by enzyme linked immunosorbent assay (Elisa). The results were analyzed by SPSS20.0 software. The normal test was used for each variable, and the quantitative data between the two groups were compared. T test was used for those who accorded with normal distribution, Kruskal-Wallis test was used for those who did not accord with normal distribution, and 蠂 2 test was used for the comparison of sample rate. When n40 or T1, the exact probability method is used. For the correlation analysis of quantitative data between two groups, the Spearman grade correlation analysis is used. The t test of the mean number of two samples is applied to the comparative analysis. Paired t test and analysis of variance. Chi-square test was used for the classification variables, and the difference test between groups was completed. The significant level of the test was bilateral test (P0.05). Results:. 1. In adult patients with epilepsy, cryptogenic, The positive rate of serum GADA in the symptomatic epilepsy group was significantly higher than that in the normal control group, and the positive rate of GADA in the cryptogenic epilepsy group was significantly higher than that in the symptomatic epilepsy group (蠂 ~ 2 ~ (2) 0.556) P ~ (0.0240.05). The positive rate of serum GADA in the symptomatic epilepsy group was significantly higher than that in the symptomatic epilepsy group. The positive rate of serum GADA in the symptomatic epilepsy group was significantly higher than that in the symptomatic epilepsy group. The positive correlation between serum GADA positive rate and fasting blood glucose abnormality in patients with cryptogenic epilepsy was 0.398 and 0.040.050.The positive rate of serum GADA was positively correlated with fasting blood glucose abnormality in patients with cryptogenic epilepsy (P < 0.05), and there was a significant positive correlation between the positive rate of serum GADA and fasting blood glucose (FBG). 2. In adult patients with epilepsy, cryptogenic, The positive rate of serum ANA in symptomatic epilepsy group was significantly higher than that in normal control group. The positive rate of ANA in cryptogenic epilepsy group was significantly higher than that in symptomatic epilepsy group (蠂 ~ 2 = 0.151). There was statistical significance between ANA positive rate and course of disease in both groups. There was no significant correlation between ANA positive rate and abnormal blood glucose in adult epileptic patients. 3There was a significant correlation between serum GADA and ANA positive rate in adult epileptic patients (蠂 2 + 18.987 0. 01%). Conclusion:. 1. Some adult epileptic patients had abnormal humoral immunity. 2. Abnormal humoral immunity was more common in adult patients with cryptogenic epilepsy than in symptomatic epilepsy. 3 GADA and ANA may be involved in the pathological process of epilepsy.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R742.1

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