难治性癫痫手术联合免疫治疗前后体液免疫状况调查.docVIP

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 (P0.01),especialy in patients who have hippocampal sclerosis, And what was increased gradually in three to six months and was significantly higher than the preoperative.IgM and C4 have no significant differences before and after operation.Conclusion：The intractable epilepsy have immune dysfunction or immunocompromised disorder,operation combined with immune therapy can effectively control the epileptic seizures or reduce the frequency of them and contribute to the improvement of immune function.【Key words】Intractable epilepsy；Immunoglobulin；Complement；Operation；Immun