抗癫(癎)药对婴儿痉挛症患儿外周血P-糖蛋白170表达的影响

目的 探讨抗癫(癎)药物(AEDs)对婴儿痉挛症(IS)患儿外周血淋巴细胞中多药耐药基因表达产物P-糖蛋白170(P-gp170)表达水平的影响.方法 应用流式细胞术检测IS患儿P-gp170的表达,根据其治疗方案不同,分为A组(托吡酯,n=6)、B组(丙戊酸钠+托吡酯,n=9)、C组(丙戊酸钠+氯硝西泮,n=6)、D组(托吡酯+氯硝西泮,n=7)、E组(健康对照组,n=8).分别于治疗前、治疗后3个月和6个月检测各组患儿外周血P-gp170表达水平.结果 A、B、C、D组在3个时间点P-gp170表达均较E组显著增高(Pa＜0.001).A、B组3个时间点P-gp170表达水平比较差异均无统计学意义,C、D组6个月时P-gp170表达较治疗前及治疗后3个月显著增高(Pa＜0.05).结论 IS患儿P-gp170外周血表达增高.丙戊酸钠和托吡酯对其表达无明显影响,而氯硝西泮长期应用可能增加P-gp170的表达.

Effect of Antiepileptic Drugs on Expression of P - Glycoprotein 170 in Peripheral Blood of Children with Infantile Spasms

Objective To explore the effect of antiepileptic drugs(AEDs) on the expression level of the drug-resistant gene expression product P-glycoprotein170(P-gp170) in the peripheral blood lymphocytes in children with infantile spasms(IS). Methods The expression of P-gp170 in peripheral blood in children with IS was measured by flow cytometry.According to the different treatment options,they were divided into group A(topiramate,n=6),group B[valproate(VPA)+topiramate,n= 9],group C(VPA+clonazepam,n= 6),group D(topiramate + clonazepam,n= 7),and group E(healthy control group,n= 8),and the expressions of P-gp170 in peripheral blood were checked before treatment,3 months and 6 months after treatment,respectively. Results The expressions of P-gp170 in group A,group B,group C and group D at three time points were all significantly higher than that in group E(Pa<0.001).The expressions of P-gp170 in group A and group B at three time points were not significantly different.The expressions of P-gp170 in group C and group D at 6 months after treatment were higher than those without treatment and 3 months after treatment(Pa<0.05). Conclusions The expression of P-gp170 increase in peripheral blood of children with IS;Sodium valproate and topiramate have no significant effect on the expression of P-gp170 in children with IS,but long-term using clonazepam can increase the expression of P-gp170.