【摘要】 目的探讨难治性癫痫患者发作间期交感神经β肾上腺素能系统的特征及美托洛尔对其的影响。方法对33例难治性癫痫患者和30名健康对照者采用放射性配基(3H-DHA)结合分析法测定外周血淋巴细胞β受体密度(βmax);用放射免疫法测定外周血淋巴细胞内环核苷酸(cyclic adenosine monophosphate,cAMP)含量;血浆去甲肾上腺素(noradrenalin,NE)含量的测定采用高效液相-电化学法。对难治性癫痫患者用美托洛尔治疗8周后再次测定上述指标并进行比较。结果与正常对照组比较,癫痫患者中病史<5年者外周血淋巴细胞β受体密度、cAMP、血浆NE浓度含量比较分别为:(271±96)fmol/107cell、(1.87±0.21)pmol/mg pro、(1.82±0.18)pmol/L(P<0.05);病史>5年者外周血淋巴细胞β受体密度、cAMP、血浆NE浓度含量比较分别为:(208±96)fmol/107cell、(1.73±0.19)pmol/mg pro、(1.93±0.15)pmol/L(P<0.01)。美托洛尔治疗8周后外周血淋巴细胞β受体密度、cAMP含量上调,血浆NE浓度明显降低。结论交感神经β肾上腺素能系统参与了癫痫发作致心脏损害的病理生理过程,美托洛尔干预处理能改善心肌细胞的信息传导,有助于损伤的心肌细胞生物学功能恢复。更多还原

【Abstract】 Objective To investigate the density of β-adrenergic system of sympathetic nervous system in lymphocytes in intractable epilepsy patients during the interictal period and whether metroprolol can influence the intractable epilepsy-induced changes in lymphocyte β-adrenoreceptor density.Methods Thirty-three patients with intractable epilepsy and 30 health controls were included in the present study.The density of β-adrenoreceptor,the cyclic nucleotide(cAMP)contents of peripheral lymphocyte and the plasma norepinephrine(NE)were examined using radioligand binding assay(3H-DHA),radioimmunity assay and HPLC combined with electrochemical detection before and eight weeks after metoprolol therapy,respectively.Results The concentrations of β-adrenoceptor(271±96 fmol/107cell)in peripheral lymphocyte,the cyclic nucleotide contents(1.87±0.21 pmol/mg pro)and the plasma norepinephrine(1.82±0.18 pmol/L)in patients with less than five year history of intractable epilepsy were significantly higher that those in controls(all P<0.05);Similarly,The concentrations of β-adrenoceptor(208±96 fmol/107cell)in peripheral lymphocyte,the cyclic nucleotide contents(1.73±0.19 pmol/mg pro)and the plasma norepinephrine(1.93±0.15 pmol/L)in patients with greater than five year history of intractable epilepsy were significantly higher that those in controls(all P<0.01).Treatment with metoprolol for 8 weeks significantly reversed epilepsy-induced changes in above parameters.Conclusions β-adrenergic system of sympathetic nervous system participates in the pathophysiological process of seizure-induced heart damage.Metoprolol can improve the signal transduction of cardiac myocytes and enhance the functional recovery of of injured cardiac myocytes.更多还原