热性惊厥患儿血浆精氨酸加压素水平的变化及其临床意义

目的 探讨精氨酸加压素(arginine vasopressin,AVP)在热性惊厥发病中的作用机制.方法 采用放射免疫分析法(RIA)测定24例复杂型热性惊厥和32例单纯型热性惊厥以及20例上呼吸道感染和18例正常对照儿童的AVP水平,并同时测定血钠和血浆渗透压水平.结果 复杂型热性惊厥组和单纯型热性惊厥组血浆AVP水平显著高于上呼吸道感染组和对照组(P＜0.05),其中复杂型热性惊厥组显著高于单纯型热性惊厥组(P＜0.05).血钠和血浆渗透压水平均表现为复杂型热性惊厥组显著低于其他各组(P＜0.01),其他各组之间无显著性差异(P》0.05).血浆AVP水平与体温水平呈正相关(r=0.71,P＜0.05).结论 测定血浆精氨酸加压素水平有助于鉴别热性惊厥的类型.精氨酸加压素可降低热性惊厥的阈值,提高惊厥的易感性,在热性惊厥的发生机制中起着重要作用.

Changes and clinical significance of plasma arginine vasopressin in children with febrile convulsion

Objective To explore the mechanism of arginine vasopressin(AVP) in the onset of febrile convulsion.Methods Radioimmunoassay(RIA) was used to determine plasma AVP levels in 24 children with complicated febrile convulsion,32 children with simple febrile convulsion,20 children with upper respiratory infection,and 18 normal children.Their plasma sodium ion and plasma osmotic pressure were measured at the same time.Results AVP level in complicated febrile convulsion group and simple febrile convulsion group was significantly higher than upper respiratory infection group and control group(P<0.05),and the level was higher in complicated febrile convulsion group than in simple febrile convulsion group(P<0.05).Plasma sodium ion and plasma osmotic pressure were lower in complicated febrile convulsion group than the other 3 groups significantly(P<0.05),and there was no significant difference among other groups.There was a positive correlation between the levels of AVP and temperature(P<0.05).Conclusion Determining plasma AVP level is conductive to identify the type of febrile convulsion.AVP can decrease the threshold of febrile convulsion and increase the susceptivity of convulsion.AVP may play an important position in the onset of febrile convulsion.