难治性癫痫手术联合免疫治疗前后体液免疫状况调查

【摘要】目的：回顾性分析难治性癫痫患者手术联合免疫治疗前后的体液免疫水平。方法：对43例难治性癫痫患者分别采取相应手术方式进行治疗，术后遵循个体化原则服用抗癫痫药，并联合胸腺肽进行治疗，随访3-6个月，采用ELISA法及速率散射浊度法对术前、术后一周、术后三个月及半年的血清免疫球蛋白及补体水平进行检测比较。结果：①临床疗效：手术后12例终止发作，13例显效，10例有效，5例效差，3例无效，海马硬化者手术效果好。②体液免疫检测结果：癫痫患者免疫球蛋白（IgA、IgG）及补体C3水平于术后一周低于术前（P﹤0.01），海马硬化者明显，术后三个月至半年逐渐升高，且明显高于术前水平。IgM及C4在手术前后无明显变化。结论：难治性癫痫患者免疫功能低下或紊乱，手术联合免疫治疗能有效控制或减少癫痫发作并有助于改善患者免疫功能。

【关键词】难治性癫痫；免疫球蛋白；补体；手术治疗；免疫治疗。

【中图分类号】R742【文献标识码】A文章编号：1004-7484（2012）-05-0797-02

【Abstract】Objective：To retrospectively analyze the immunity of patients with intractable epilepsy who have taken operation and immunethreapy.Methods：Forty-three cases of patients with intractable epilepsy were taken appropriate operation spectively, supplemented with postoperative antiepileptic drugs and thymosin for treatment,following up for three to six months.using the method of ELISA and rate nephelometric turbidity method to test the immunoglobulin and complement in serum in the time of preoperative, postoperative week, three months after the operation and six month after that.Results：First,the clinical curative effect of forty-three is that twelve cases aquired freedom after operation,ten cases of effective,five cases of poor effects and 3 cases ineffective,the patients who had hippocampal sclerosis aquired better effect than others.Second, the immunoglobulin (IgA,IgG ) and C3 of postoperative week are lower than that of properation (P

1.1对象：收集我院2009年9月-2011年3月难治性癫痫患者43例，所有患者均无免疫性疾病并且近期无免疫性药物使用史，其中男28例，女15例，年龄1岁-45岁，平均年龄18±2.5岁。病程6个月-15年。其中失神发作5例，全面强直阵挛性发作20例，局部运动性发作病10例，复杂部分性发作伴失张力发作8例，发作期间脑电图均有异常，表现为尖波，尖慢波，棘波，棘慢波，节律紊乱等。