[1]孔敏,蒋莉,洪思琪,等.癫痫儿童外周血p-糖蛋白水平在预测儿童抗癫痫药物疗效中的作用[J].第三军医大学学报,2013,35(02):153-156.
 Kong Min,Jiang Li,Hong Siqi,et al.Role of peripheral P-glycoprotein in predicting efficacy of antiepileptic drugs in epilepsy children[J].J Third Mil Med Univ,2013,35(02):153-156.
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癫痫儿童外周血p-糖蛋白水平在预测儿童抗癫痫药物疗效中的作用(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
35卷
期数:
2013年第02期
页码:
153-156
栏目:
论著
出版日期:
2013-01-30

文章信息/Info

Title:
Role of peripheral P-glycoprotein in predicting efficacy of antiepileptic drugs in epilepsy children
作者:
孔敏蒋莉洪思琪胡君叶园珍
重庆医科大学附属儿童医院神经内科
Author(s):
Kong Min Jiang Li Hong Siqi Hu Jun Ye Yuanzhen
Department of Pediatric Neurology, Children’s Hospital, Chongqing Medical University, Chongqing, 400014, China
关键词:
癫痫抗癫痫药物p-糖蛋白外周血儿童
Keywords:
epilepsy antiepileptic drugsP-glycoproteinperipheral bloodchildren
分类号:
R446.112;R742.1;R969.4
文献标志码:
A
摘要:
目的      检测癫痫儿童外周血p-糖蛋白(P-glycoprotein, P-gp)表达的动态变化,探讨其与癫痫耐药的关系及在预测儿童抗癫痫药物(antiepileptic drugs, AEDs)疗效中的价值。      方法      选取难治性癫痫患儿30例、初诊癫痫患儿40例及健康体检儿童30例,分别于入组前和治疗后6、12、18个月,用流式细胞仪检测P-gp的表达,分析P-gp表达水平与癫痫发作频率和应用AEDs抗癫痫疗效的关系。      结果      难治性癫痫组、初诊癫痫组在各个观察时间点P-gp表达较健康对照组均显著增高(P<0.01);难治性癫痫组各个观察时间点P-gp表达较初诊癫痫组显著增高(P<0.05);难治性癫痫组各个观察时间点P-gp的表达比较差异有显著性(P<0.01,P<0.05),初诊癫痫组各个观察时间点P-gp的表达比较差异无统计学意义(P>0.05)。难治性癫痫组入组前P-gp表达阳性19例中16例(84.2%)经换药或加药治疗无效,表达阴性11例中3例(27.3%)无效,两者比较差异有统计学意义(P<0.01);初诊癫痫组入组前P-gp表达阳性13例中9例(69.2%)转化为难治性癫痫,表达阴性27例中2例(7.4%)转化为难治性癫痫,两者比较差异有统计学意义(P<0.01)。发作频繁患儿P-gp水平明显高于发作较少患儿(P<0.01);使用4种AEDs患儿P-gp水平明显高于使用2种及3种AEDs(P<0.01)。      结论      癫痫患儿外周血P-gp表达升高,难治性癫痫升高更明显,可能是临床耐药的原因,可作为评价抗癫痫药物疗效的预测指标。
Abstract:
Objective      To observe the dynamic changes of the expression of P-glycoprotein(P-gp)in peripheral blood in children with epilepsy, and to explore the relationship between P-gp and epileptic resistance and its value of predicting efficacy of antiepileptic drugs (AEDs).       Methods      A total of 70 inpatients and outpatients in our department from January 2011 to July 2012 were subjected in this study. These children were divided into refractory epilepsy (group A, n=30, age ranging from 13 months to 15 years), and newly diagnosed epilepsy(group B, n=40, age ranging from 2 months to 14 years). Another 30 sex and age matched healthy children (group C) served as normal control. The expression of P-gp in peripheral blood was detected by flow cytometry before treatment, and in 6, 12 and 18 months after treatment, respectively. The expression of P-gp and its relationship with epileptic frequency and therapeutic effect of AEDs were analyzed.       Results      The expression of P-gp in group A and group B at every time point were all significantly higher than that in group C(P<0.01), and that in group A were all significantly higher than that in group B(P<0.01). Significant difference was also found in the expression of the P-gp in group A at difference time points(P<0.01,P<0.05), but was not found in group B. Among the 19 cases with positive P-gp before treatment in group A, 16 out of them (84.2%)were invalid after changing or adding AEDs, but only 3 out of 11 cases (27.3%)with no P-gp expression became invalid, and there was a significant difference between them (P<0.01). In group B, 9 out of 13 cases (69.2%)with P-gp expression before treatment became intractable, but only 2 out of 27 (7.4%) with no P-gp expression became intractable, there was a significant difference between them (P<0.01). P-gp expression was stronger in the patients with high frequent epilepsy than those with low frequency(P<0.01). P-gp expression was also stronger in patients administered with 4 kinds of AEDs than those with 2 or 3 kinds of AEDs(P<0.01).       Conclusion      The high level of P-gp increase in peripheral blood of children with epilepsy predicts refractory epilepsy. The increased expression of P-gp may play an important role in clinical drug resistance. It also can be used as a predictable marker of evaluating efficacy of AEDs.

参考文献/References:

孔敏, 蒋莉, 洪思琪, 等. 癫痫儿童外周血p-糖蛋白水平在预测儿童抗癫痫药物疗效中的作用[J].第三军医大学学报,2013,35(2):153-156.

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更新日期/Last Update: 2013-01-18