血Ghrelin水平在癲癇患者中的變化及意義
發(fā)布時(shí)間：2018-12-28 09:34
【摘要】：目的： 癲癇(Epilepsy)是由大腦神經(jīng)元異常放電引起的以短暫性中樞神經(jīng)系統(tǒng)功能失常為特征的慢性腦部疾病,以神經(jīng)功能失常為特征,反復(fù)發(fā)作,嚴(yán)重影響患者的生命質(zhì)量。癲癇發(fā)病機(jī)制復(fù)雜,研究證實(shí)癲癇患者神經(jīng)內(nèi)分泌系統(tǒng)發(fā)生變化,其原因不詳,可能與肽類激素ghrelin有關(guān)。Ghrelin是一種含有28個(gè)氨基酸的生長(zhǎng)激素釋放肽,主要由胃底X／A樣內(nèi)分泌細(xì)胞分泌,并廣泛分布于垂體、下丘腦等組織器官。本文通過(guò)研究癲癇患者ghrelin的變化特征,初步探討其表達(dá)意義,以期在癲癇診治和療效評(píng)估中建立更為便捷、敏感的方法,為更深入的研究癲癇發(fā)病機(jī)制提供理論依據(jù),為臨床治療提供新思路。 方法： 選取特發(fā)性癲癇患者40人,分成兩組：全面性發(fā)作組(Primary generalized seizure, PGE)18人,男7人,女11人,年齡23～42歲,病程6個(gè)月～30年,其中8人為新診斷,入組時(shí)未應(yīng)用藥物治療,其余10人已應(yīng)用丙戊酸鈉治療3個(gè)月以上；部分性發(fā)作組(Partial seizure, PE)22人,男9人,女13人,年齡24～43歲,病程6個(gè)月-30年,其中8人為新診斷,入組時(shí)未應(yīng)用藥物治療,其余16人已應(yīng)用卡馬西平治療3個(gè)月以上；并選取健康體檢者28人作為正常對(duì)照組,男12人,女16人,年齡25～43歲。以標(biāo)準(zhǔn)方法測(cè)量各研究對(duì)象身高、體重,計(jì)算體重指數(shù),應(yīng)用酶聯(lián)免疫吸附試驗(yàn)(Enzyme-linked immunoadsorbent assay, ELISA)檢測(cè)患者空腹血清Ghrelin水平,同步測(cè)定血.糖(Fasting blood glucose, FBG)、甘油三酯(Triglyceride, TG)、總膽固醇(Total cholestero1)、高密度脂蛋白膽固醇(High-density lipoprotein cholesterol, HDL-c)、低密度脂蛋白膽固醇(Low-density lipoprotein cholesterol, LDL-c),搜集臨床資料,分析一般臨床特征包括：年齡、性別、體重指數(shù)等,并與正常對(duì)照組比較,進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果： 1.特發(fā)性癲癇組血清Ghrelin濃度為44.35±11.07pg/ml,對(duì)照組為75.37±8.52pg/ml。特發(fā)性癲癇組血清Ghrelin水平較對(duì)照組明顯降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05), 2.部分性發(fā)作組血清Ghrel in濃度為50.52±9.55pg/ml,較全面性發(fā)作組ghrelin水平(37.39±7.89pg/m1)升高,差異有統(tǒng)計(jì)學(xué)意義。 3.全面性發(fā)作癲癇丙戊酸鈉治療后組Ghrelin濃度為39.86±6.22pg/ml,較全面性發(fā)作未治療組30.31±3.47pg/ml升高,但仍較對(duì)照組低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 4.部分性發(fā)作癲癇組卡馬西平治療后組Ghrelin濃度為55.45±5.21pg/ml,較全面性發(fā)作未治療組41.88±9.46pg/ml升高,但仍較對(duì)照組低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論：1.特發(fā)性癲癇患者血清Ghrelin水平低于正常,部分性發(fā)作癲癇組Ghrelin水平較全面性發(fā)作癲癇組水平高,提示Ghrelin可能在癲癇發(fā)作中起重要作用。 2.全面性發(fā)作癲癇組經(jīng)丙戊酸鈉治療組Ghrelin水平較全面性發(fā)作未治療組升高,部分性發(fā)作卡馬西平治療組Ghrelin水平較部分性發(fā)作未治療組升高,提示高的Ghrelin水平可能有抗癲癇作用。
[Abstract]:Objective: epileptic (Epilepsy) is a chronic brain disease characterized by transient central nervous system dysfunction caused by abnormal discharges of brain neurons. The quality of life of patients is seriously affected. The pathogenesis of epilepsy is complicated. It has been proved that the neuroendocrine system changes in epileptic patients, and the reason is unknown, which may be related to the peptide hormone ghrelin. Ghrelin is a growth hormone releasing peptide containing 28 amino acids. It is mainly secreted by X-A-like endocrine cells in the gastric fundus and widely distributed in pituitary hypothalamus and other tissues and organs. In order to establish a more convenient and sensitive method for the diagnosis and treatment of epilepsy and the evaluation of therapeutic effect, this paper studies the change characteristics of ghrelin in epileptic patients and preliminarily discusses its expression significance, which provides theoretical basis for further study on the pathogenesis of epilepsy. To provide new ideas for clinical treatment. Methods: forty patients with idiopathic epilepsy were divided into two groups: 18 patients with (Primary generalized seizure, PGE), 7 males and 11 females, aged 2342 years, with the course of 6 months to 30 years, 8 of whom were newly diagnosed. The other 10 patients had been treated with sodium valproate for more than 3 months. There were 22 (Partial seizure, PE) patients (9 males, 13 females) in the partial onset group, aged 24 to 43 years. The course of the disease was 6 months to 30 years, 8 of them were newly diagnosed and were not treated with drugs at the time of entering the group. The remaining 16 patients had been treated with carbamazepine for more than 3 months. 28 healthy persons were selected as normal control group, 12 males and 16 females, aged 25 ~ 43 years. The height, weight and body mass index were measured by standard method. Serum Ghrelin levels were measured by Enzyme-linked immunoadsorbent assay, ELISA) and blood samples were measured simultaneously by enzyme-linked immunosorbent assay (Enzyme-linked immunoadsorbent assay, ELISA). Sugar (Fasting blood glucose, FBG), triglyceride (Triglyceride, TG), total cholesterol (Total cholestero1), high density lipoprotein cholesterol (High-density lipoprotein cholesterol, HDL-c), low density lipoprotein cholesterol (Low-density lipoprotein cholesterol, LDL-c) were collected. The general clinical features included age, sex, body mass index, and compared with the normal control group. Results: 1. The serum Ghrelin concentration was 44.35 鹵11.07pg / ml in the idiopathic epilepsy group and 75.37 鹵8.52pg / ml in the control group. The serum Ghrelin level in Idiopathic Epilepsy group was significantly lower than that in the control group (P0.05). The serum Ghrel in level in partial seizure group was 50.52 鹵9.55pg / ml, which was significantly higher than that in comprehensive seizure group (37.39 鹵7.89pg/m1). 3. The concentration of Ghrelin was 39.86 鹵6.22pg / ml after treatment with sodium valproate, which was higher than that of untreated group (30.31 鹵3.47pg/ml), but still lower than that of control group (P0.05). 4. The concentration of Ghrelin in patients with partial seizure epilepsy was 55.45 鹵5.21pg / ml after carbamazepine treatment, which was higher than that in patients without generalized seizure (41.88 鹵9.46pg/ml), but still lower than that in control group (P0.05). Conclusion: 1. The serum Ghrelin level of idiopathic epilepsy patients was lower than that of normal patients, and the level of Ghrelin in partial seizure group was higher than that in generalized seizure group, suggesting that Ghrelin might play an important role in epileptic seizures. 2. The level of Ghrelin in the group treated with sodium valproate was higher than that in the group without comprehensive seizure, and the level of Ghrelin in the group treated with carbamazepine was higher than that in the group without partial seizure, suggesting that the high level of Ghrelin might have antiepileptic effect.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R742.1
本文編號(hào)：2393789
[Abstract]:Objective: epileptic (Epilepsy) is a chronic brain disease characterized by transient central nervous system dysfunction caused by abnormal discharges of brain neurons. The quality of life of patients is seriously affected. The pathogenesis of epilepsy is complicated. It has been proved that the neuroendocrine system changes in epileptic patients, and the reason is unknown, which may be related to the peptide hormone ghrelin. Ghrelin is a growth hormone releasing peptide containing 28 amino acids. It is mainly secreted by X-A-like endocrine cells in the gastric fundus and widely distributed in pituitary hypothalamus and other tissues and organs. In order to establish a more convenient and sensitive method for the diagnosis and treatment of epilepsy and the evaluation of therapeutic effect, this paper studies the change characteristics of ghrelin in epileptic patients and preliminarily discusses its expression significance, which provides theoretical basis for further study on the pathogenesis of epilepsy. To provide new ideas for clinical treatment. Methods: forty patients with idiopathic epilepsy were divided into two groups: 18 patients with (Primary generalized seizure, PGE), 7 males and 11 females, aged 2342 years, with the course of 6 months to 30 years, 8 of whom were newly diagnosed. The other 10 patients had been treated with sodium valproate for more than 3 months. There were 22 (Partial seizure, PE) patients (9 males, 13 females) in the partial onset group, aged 24 to 43 years. The course of the disease was 6 months to 30 years, 8 of them were newly diagnosed and were not treated with drugs at the time of entering the group. The remaining 16 patients had been treated with carbamazepine for more than 3 months. 28 healthy persons were selected as normal control group, 12 males and 16 females, aged 25 ~ 43 years. The height, weight and body mass index were measured by standard method. Serum Ghrelin levels were measured by Enzyme-linked immunoadsorbent assay, ELISA) and blood samples were measured simultaneously by enzyme-linked immunosorbent assay (Enzyme-linked immunoadsorbent assay, ELISA). Sugar (Fasting blood glucose, FBG), triglyceride (Triglyceride, TG), total cholesterol (Total cholestero1), high density lipoprotein cholesterol (High-density lipoprotein cholesterol, HDL-c), low density lipoprotein cholesterol (Low-density lipoprotein cholesterol, LDL-c) were collected. The general clinical features included age, sex, body mass index, and compared with the normal control group. Results: 1. The serum Ghrelin concentration was 44.35 鹵11.07pg / ml in the idiopathic epilepsy group and 75.37 鹵8.52pg / ml in the control group. The serum Ghrelin level in Idiopathic Epilepsy group was significantly lower than that in the control group (P0.05). The serum Ghrel in level in partial seizure group was 50.52 鹵9.55pg / ml, which was significantly higher than that in comprehensive seizure group (37.39 鹵7.89pg/m1). 3. The concentration of Ghrelin was 39.86 鹵6.22pg / ml after treatment with sodium valproate, which was higher than that of untreated group (30.31 鹵3.47pg/ml), but still lower than that of control group (P0.05). 4. The concentration of Ghrelin in patients with partial seizure epilepsy was 55.45 鹵5.21pg / ml after carbamazepine treatment, which was higher than that in patients without generalized seizure (41.88 鹵9.46pg/ml), but still lower than that in control group (P0.05). Conclusion: 1. The serum Ghrelin level of idiopathic epilepsy patients was lower than that of normal patients, and the level of Ghrelin in partial seizure group was higher than that in generalized seizure group, suggesting that Ghrelin might play an important role in epileptic seizures. 2. The level of Ghrelin in the group treated with sodium valproate was higher than that in the group without comprehensive seizure, and the level of Ghrelin in the group treated with carbamazepine was higher than that in the group without partial seizure, suggesting that the high level of Ghrelin might have antiepileptic effect.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R742.1
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