药物难治性癫痫患者脑内多种耐药基因表达的初步研究

目的研究药物难治性癫痫患者与正常对照组脑内多种药物耐药基因（ＭＤＲ１）表达的情况。方法　选择１５例药物难治性癫痫患者和５例对照组患者的脑组织标本，用逆转录聚合酶链反应（ＲＴ－ＰＣＲ）技术，以Ｂ－ａｃｔｉｎ为内参照对ＭＤＲ１基因进行扩增，经琼脂糖凝胶电泳分别得到２２６ｂｐ和５４８ｂｐ的条带，通过照相、扫描、计算ＭＤＲ１／ｂ－ａｃｔｉｎ比值进行半定量分析。结果统计学处理提示，药物难治性癫痫患者脑内ＭＤＲ１的表达明显高于对照组（Ｐ＜０．０１）。结论　Ｐ－糖蛋白为ＭＤＲ１的产物，能将药物从脑内排入血循环而降低脑内药物浓度。药物难治性癫痫患者因脑内ＭＤＲ１的高表达，导致脑内抗癫痫药物（ＡＥＤ）浓度较低而耐药。故应用ＭＤＲ１抑制剂也许可以提高ＡＥＤ在脑内的药物浓度，使癫痫的药物治疗效果更令人满意。

Study on MDR1 gene expression in brain of patients with medically intractable epilepsy

Objective To study multidrug resistance (MDR1) gene expression in brain of patients withmedically intractable epilepsy Methods Brain specimens of 15 patients with drug-resistant epilepsy and 5 controlpatients were collected The MDR1 and B-actin wer simultaneously amplied in RT-PCR reaction The B-actin waschosen as a control to verify that the RNA was sufficient quality for the RT-PCR. Two hands (226hp and 548bp)were attained by an agarose gel electrophoresis. Following the process of photography, scan and calculation, a semiquantitative analysis was completed. Results Compeared with that of the control group, MDR1 expression in brainspecimens of the epilepsy patients showed an obviously statistical increasing (P <0.01). Conclusions It is wellknown that P-glycoprotein, encoded by MDR1, exports he from brain cells into blood then lowers drug concentrations in brain. MDR1 overe xpression in brain of Patients with medically intractable epilepsy can export AEDs frombrain and contribute to the refectory nature of their seizures. It is probable that MDR1 inhibitors may increase AEDconcentrations in brains and decrease seizure frequency