癫痫发作后患儿血清和脑脊液中神经元特异性烯醇化酶S-100β蛋白髓鞘碱性蛋白的变化

目的　探讨癫痫发作是否引起脑损伤 ,生化标志物能否作为癫痫发作后脑细胞损伤早期诊断的指标。方法　应用电化学发光法和酶联免疫反应法测定癫痫发作后 2 4h内患儿血清和脑脊液 (CSF)中神经元特异性烯醇化酶 (NSE)、S 10 0 β蛋白 (S 10 0 β)、髓鞘碱性蛋白 (MBP)水平的含量。 结果　癫痫非反复发作组血清和CSF中NSE、S 10 0 β含量明显高于对照组 ,差异有非常显著性 (均 P <0 .0 1) ;癫痫反复发作组血清和CSF中NSE、S 10 0 β含量又明显高于非反复发作组 ,差异有显著性 (均 P <0 .0 5 ) ;持续状态组血清和CSF中NSE、S 10 0 β含量亦显著高于非反复发作组 ,差异有非常显著性 (均P <0 .0 1) ;但癫痫反复发作组与持续状态组比较 ,血清和CSF中NSE、S 10 0 β含量差异均无显著性意义 (均 P >0 .0 5 )。各组血清和CSF中MBP含量与对照组相比差异无显著性(均P >0 .0 5 )。结论　癫痫发作后 2 4h内血清和CSF中NSE和S 10 0 β已明显升高 ,两者均能作为癫痫发作后脑细胞损伤的早期指标 ;MBP不能作为癫痫发作后脑细胞损伤的早期诊断指标。

Changes of serum and cerebrospinal fluid neron-specific enolase, S-100β and myelin basic protein levels in children with epilepsy after seizures

Objective To study the changes of serum and cerebrospinal fluid (CSF) levels of neuron-specific enolase (NSE), S-100β protein (S-100β) and myelin basic protein (MBP) in children with epilepsy (EP) after seizures, so as to evaluate their significance in early diagnosis of neuronal damage. Methods The serum and CSF levels of NSE, S-100β and MBP in children with EP (EP group, including 12 cases of frenquent seizures, 13 infrenquent seizures and 6 status epilepticus) were determined respectively by electrochemiluminescence and enzyme-linked immunosorbent assay within 24 hrs after seizures. Samples were obtained from thirty-eight children with upper respiratory infection and these were used as the Control group. Results The serum and CSF levels of NSE and S-100β in the EP group within 24 hrs after seizures were significantly higher than those in the Control group (P< 0.01). Of the EP group, the serum and CSF levels of NSE and S-100β in children with frenquent seizures and children with status epilepticus were significantly higher than in children with infrenquent seizures (P< 0.05 and P< 0.01, respectively), while there were no significant differences between the children with frenquent seizures and ones with status epilepticus. There were no statistically significant differences in serum and CSF MBP levels between the EP and Control groups. Conclusions NSE and S-100β in serum and CSF may be markers of neuronal damage following seizures, while MBP is not correlated with neuronal damage.