托吡酯联合丙戊酸治疗对婴儿痉挛症患儿外周血淋巴细胞主穹隆蛋白表达的影响

摘要

Objective To observe the effects of anti-epileptic drugs on the expression of major vault protein (MVP) in the peripheral blood lymphocytes of children with infantile spasm and discuss the resistant mechanism of infantile spasm.Methods A total of 30 infantile spasm children who were admitted into our hospital from January 2014 to February 2016 were selected and set as an experimental group.Meanwhile, another 30 healthy children who underwent physical examination in our hospital was selected and set as a blank control group.After diagnosed, infantile spasm children were immediately orally administrated with sodium valproate and topiramate for more than six months.The level of MVP was detected by Western blotting before and six months after administration.Results A small amount of MVP was detected in the peripheral blood of the blank control group.MVP protein was highly expressed in infantile spasm children before administration, which were statistically different from those of the blank control group (P<0.05).The level of MVP was remarkably reduced in the treatment groups (P<0.05).Conclusions MVP may play an important role in the development of resistance of infantile spasm.Sodium valproate combined with topiramate can prevent the seizure of infantile spasm children, and reduce the expression of MVP.%目的 通过观察抗癫痫药物对婴儿痉挛症患儿外周血淋巴细胞主穹窿蛋白(MVP)表达的影响,探讨婴儿痉挛症耐药的部分机制.方法 以2014年1月-2016年2月无锡市儿童医院门诊及住院收治的婴儿痉挛症患儿30例为治疗组,选取同期来院体检的健康儿童30例为正常对照组.婴儿痉挛症患儿确诊后立即口服丙戊酸、托吡酯,治疗时间均超过6个月;用药前、用药后6个月应用免疫蛋白印记(Western blot)方法检测外周血淋巴细胞MVP蛋白的表达.结果 治疗组用药6个月后总效率66.7%.正常对照组儿童外周血中有少量MVP表达.婴儿痉挛症患儿用药前MVP大量表达,与正常对照组比较差异有统计学意义(P<0.05).治疗组在用药后6个月MVP较用药前降低,差异有统计学意义(P<0.05). 结论 MVP可能参与婴儿痉挛症耐药的发生,丙戊酸联合托吡酯可以控制婴儿痉挛发作,并可能下调MVP的表达.