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目的观察血浆、脑脊液中神经肽Y(NPY)的质量浓度变化,探讨NPY在惊厥性疾病中的作用及临床意义。方法选取2002-09—2003-08在陕西省人民医院儿科住院的惊厥性疾病患儿,采用放射免疫分析方法检测血浆和脑脊液中NPY的质量浓度。结果(1)惊厥组血浆中NPY质量浓度第7天较第1天增高,差异有显著性(t=5·366,P<0·01),惊厥组各组第7天与第1天自身比较差异有显著性(t=3·509,3·480,3·379,P<0·05);脑炎无惊厥组第7天较第1天增高,但差异无显著性(t=1·056,P=0·309);惊厥组与脑炎无惊厥组、对照组相比,差异有显著性(t=5·728,P<0·01;t=6·990,P<0·001),脑炎无惊厥组与对照组比较差异无显著性意义(t=0·987,P>0·05),惊厥组各组之间差异也有显著性(F=34·674,P<0·01)。(2)惊厥组脑脊液中NPY质量浓度与脑炎无惊厥组、对照组比较差异有显著性(t=7·830,5·699,P<0·001),脑炎无惊厥组与对照组比较差异无显著性(t=0·112,P=0·911),惊厥组各组之间差异也有显著性(F=68·931,P<0·01)。(3)血浆和脑脊液中NPY质量浓度与惊厥发作次数有关(P<0·05),与性别、年龄、体重无显着相关,P均大于0·05;第1、7天血浆NPY质量浓度与第1天脑脊液NPY质量浓度有显着正相关性(r=0·954,P<0·001;r=0·950,P<0·001)。结论(1)惊厥性疾病患儿血浆、脑脊液中NPY质量浓度均增高,与惊厥发作次数有关,但在惊厥发生的不同阶段质量浓度不同。(2)血浆与脑脊液中NPY质量浓度呈正相关性,血浆中的质量浓度能间接反映脑脊液质量浓度。提示动态监测NPY质量浓度可能有助于对惊厥的临床诊断、治疗及预后的判断。
Objective To observe the changes of neuropeptide Y (NPY) concentration in plasma and cerebrospinal fluid (CSF) and to explore the role and clinical significance of NPY in patients with convulsive diseases. Methods Children with congenital heart disease hospitalized in Shaanxi Provincial People’s Hospital from September 2002 to August 2003 were selected to detect the concentration of NPY in plasma and cerebrospinal fluid by radioimmunoassay. Results (1) The concentration of NPY in the seizure group was higher on the 7th day than that on the 1st day (t = 5 · 366, P <0.01), and on the 7th day and the 1st day in the seizure group The difference was significant (t = 3.509,3.480,3.379, P <0.05); encephalitis without convulsion group increased on the 7th day compared with the first day, but the difference was not significant (t = 1 · 056, P = 0 · 309). There was significant difference between convulsion group and encephalitis without convulsion group and control group (t = 5.72, P <0.01; t = 6.990, P < There was no significant difference between the two groups (F = 34.674, P <0.001). There was no significant difference between the convulsion group and the control group (t = 0.987, P> 0.05) <0 · 01). (2) The concentration of NPY in cerebrospinal fluid in convulsion group was significantly lower than that in encephalitis group without convulsion (t = 7 · 830,5.699, P <0.001) There was no significant difference between the two groups (t = 0.121, P = 0.91 1). There was also significant difference between each group in the seizure group (F = 68.931, P <0.01). (3) The concentration of NPY in plasma and cerebrospinal fluid was correlated with the number of seizures (P <0.05), but not with gender, age and body weight (P> 0.05). The plasma NPY concentration There was a significant positive correlation between the concentration of NPY and cerebrospinal fluid (r = 0.954, P <0.001; r = 0.950, P <0.001) on the first day. Conclusions (1) In children with convulsion disease, NPY concentration in plasma and cerebrospinal fluid increased, which was related to the number of convulsions. However, the concentrations of NPY in different stages of convulsion were different. (2) Plasma and cerebrospinal fluid concentration of NPY was positively correlated, the concentration of plasma can indirectly reflect the concentration of cerebrospinal fluid. It is suggested that the dynamic monitoring of NPY concentration may be helpful to the clinical diagnosis, treatment and prognosis of convulsions.