中国神经精神疾病杂志
中國神經精神疾病雜誌
중국신경정신질병잡지
CHINESE JOURNAL OF NERVOUS AND MENTAL DISEASES
2015年
8期
466-470
,共5页
难治性癫痫%多耐药基因1P糖蛋白%谷胱甘肽S转移酶
難治性癲癇%多耐藥基因1P糖蛋白%穀胱甘肽S轉移酶
난치성전간%다내약기인1P당단백%곡광감태S전이매
Intractable epilepsy(IE)%Multiple drug resistance genes1(MDR1)%P glycoprotein(P-gp)%Glutathi-one S transferase Pi(GST-Pi)
目的：通过对难治性癫痫（intractable epilepsy，IE）患者外周血中多耐药基因（multidrug resistance 1， MDR1）、P糖蛋白（p glycoprotein，P-gp）及谷胱甘肽转移酶（glutathione transferaseπ，GST-Pi）的检测来探讨IE的发病机制；探讨这3项指标作为患者外周血标志物对临床治疗的指导意义。方法本研究分为3组，IE患者31例，抗癫痫药物（antiepileptic drugs，AEDs）控制良好者33例，健康者37例。采用荧光定量聚合酶链反应技术检测患者外周血中MDR1及GST-Pi的mRNA、流式细胞术检测患者外周血中MDR1的表达产物P-gp的表达。结果在MDR1基因与GST-Pi基因相对表达量方面，IE组（1.36±0.14，0.585±0.257）显著高于AEDs治疗有效组（0.82±0.15,0.309±0.217），（P＜0.05）；而AEDs治疗有效组又显著高于正常组（0.27±0.07,0.134±0.223），（P＜0.05）。在白细胞P-gp方面，IE组（0.104±0.084）显著高于AEDs治疗有效组（0.063±0.030），（P＜0.05）。在用药方式上，GST-Pi基因相对表达量方面，给予3种（0.535±0.256）及2种（0.425±0.254）AEDs联合治疗均显著高于给单药（0.267±0.265）治疗，（P＜0.05）；在白细胞P-gp方面，3种（0.141±0.096）AEDs联合治疗显著高于2种（0.071±0.020）AEDs联合治疗与单药（0.050±0.020）治疗，（P＜0.05）。结论癫痫患者外周血中的MDR1、P-gp及GST-Pi基因相对表达量或可作为IE的综合参考指标以及IE联合用药的耐药指标之一。
目的：通過對難治性癲癇（intractable epilepsy，IE）患者外週血中多耐藥基因（multidrug resistance 1， MDR1）、P糖蛋白（p glycoprotein，P-gp）及穀胱甘肽轉移酶（glutathione transferaseπ，GST-Pi）的檢測來探討IE的髮病機製；探討這3項指標作為患者外週血標誌物對臨床治療的指導意義。方法本研究分為3組，IE患者31例，抗癲癇藥物（antiepileptic drugs，AEDs）控製良好者33例，健康者37例。採用熒光定量聚閤酶鏈反應技術檢測患者外週血中MDR1及GST-Pi的mRNA、流式細胞術檢測患者外週血中MDR1的錶達產物P-gp的錶達。結果在MDR1基因與GST-Pi基因相對錶達量方麵，IE組（1.36±0.14，0.585±0.257）顯著高于AEDs治療有效組（0.82±0.15,0.309±0.217），（P＜0.05）；而AEDs治療有效組又顯著高于正常組（0.27±0.07,0.134±0.223），（P＜0.05）。在白細胞P-gp方麵，IE組（0.104±0.084）顯著高于AEDs治療有效組（0.063±0.030），（P＜0.05）。在用藥方式上，GST-Pi基因相對錶達量方麵，給予3種（0.535±0.256）及2種（0.425±0.254）AEDs聯閤治療均顯著高于給單藥（0.267±0.265）治療，（P＜0.05）；在白細胞P-gp方麵，3種（0.141±0.096）AEDs聯閤治療顯著高于2種（0.071±0.020）AEDs聯閤治療與單藥（0.050±0.020）治療，（P＜0.05）。結論癲癇患者外週血中的MDR1、P-gp及GST-Pi基因相對錶達量或可作為IE的綜閤參攷指標以及IE聯閤用藥的耐藥指標之一。
목적：통과대난치성전간（intractable epilepsy，IE）환자외주혈중다내약기인（multidrug resistance 1， MDR1）、P당단백（p glycoprotein，P-gp）급곡광감태전이매（glutathione transferaseπ，GST-Pi）적검측래탐토IE적발병궤제；탐토저3항지표작위환자외주혈표지물대림상치료적지도의의。방법본연구분위3조，IE환자31례，항전간약물（antiepileptic drugs，AEDs）공제량호자33례，건강자37례。채용형광정량취합매련반응기술검측환자외주혈중MDR1급GST-Pi적mRNA、류식세포술검측환자외주혈중MDR1적표체산물P-gp적표체。결과재MDR1기인여GST-Pi기인상대표체량방면，IE조（1.36±0.14，0.585±0.257）현저고우AEDs치료유효조（0.82±0.15,0.309±0.217），（P＜0.05）；이AEDs치료유효조우현저고우정상조（0.27±0.07,0.134±0.223），（P＜0.05）。재백세포P-gp방면，IE조（0.104±0.084）현저고우AEDs치료유효조（0.063±0.030），（P＜0.05）。재용약방식상，GST-Pi기인상대표체량방면，급여3충（0.535±0.256）급2충（0.425±0.254）AEDs연합치료균현저고우급단약（0.267±0.265）치료，（P＜0.05）；재백세포P-gp방면，3충（0.141±0.096）AEDs연합치료현저고우2충（0.071±0.020）AEDs연합치료여단약（0.050±0.020）치료，（P＜0.05）。결론전간환자외주혈중적MDR1、P-gp급GST-Pi기인상대표체량혹가작위IE적종합삼고지표이급IE연합용약적내약지표지일。
Objective The pathogenesis of intractable epilepsy was explored by examining the expression of the P-gp , GST-Pi as well as MDR1 in peripheral blood of the patients with intractable epilepsy. The potential of the above mentioned three genes as the biomarkers for treatment of intractable epilepsy was investigated. Methods Thirty-one sub?jects with refractory epilepsy, 33 subjects under good circumstances by antiepileptic drugs, and 37 healthy subjects were included in the present study. fluorescence quantitative polymerase chain reaction and flow cytometry were used to detect mRNA levels of MDR1 and GST-Pi and P-gp of MDR1 in the peripheral blood of the patients, respectively. Results The expression levels of MDR1 and GST-Pi were significantly higher in the AEDs intractable group(1.36±0.14,0.585±0.257) than in the treatment group(0.82±0.15,0.309±0.217, P<0.05)The expression levels of MDR1 and GST-Pi were signifi?cantly higher in the AEDs treatment group than in the normal group(0.27±0.07,0.134±0.223,P<0.05). The expression levels of P-gp were significantly higher in the AEDs of the intractable group(0.104±0.084)than in the treatment group (0.063 ± 0.030, P<0.05). The GST-Pi gene expression levels were significantly higher in three(0.535 ± 0.256)or two (0.425±0.254)kinds of antiepileptic drugs combination therapy than in single drug treatment(0.267±0.265, P<0.05). Leucocyte P-gp levels were significantly higher in combination therapy of three kinds of antiepileptic drugs(0.141 ± 0.096)than in combination therapy of two kinds of antiepileptic drugs(0.071±0.020)or in monotherapy(0.050±0.020, P<0.05). Conclusion MDR1 and GST-Pi gene expression levels of peripheral blood can be used as the reference in?dex for treatment of intractable epilepsy and the resistant index of combination treatment for intractable epilepsy.
