【摘要】 目的:探讨初发癫癎患者与难治性癫癎患者血清中蛋白质指纹图谱的差异性,并观察其与难治性癫癎患者预后的关系。方法:对我院神经内科门诊2008年10月至2010年10月就诊的1653例癫癎患者,根据国际抗癫癎联盟(ILAE)癫癎发作的分类方案,结合中华医学会《临床诊疗指南-癫癎病分册》癫癎的诊断原则和方法,筛选初发癫癎患者20例,难治性癫癎患者20例,抽取患者血清标本,用美国Ciphergen Biosystem公司的蛋白质指纹仪及WCX2蛋白质芯片,经蛋白质指纹图谱技术(SELDI-TOF-MS)检测两组患者血清的蛋白指纹图谱,比较其间的差异性;并对难治性癫癎的蛋白指纹图谱与其预后的相关性进行分析。结果:在指纹图上,质荷比(M/Z)为11100Da至11900Da之间出现一峰簇样指纹标志,且蛋白峰值大于5%。该质谱峰簇丰度在难治性癫癎患者中明显高于初发癫癎患者(P<0.01);采用Spearman相关分析难治性癫癎患者质谱峰簇丰度与其预后呈负相关(r=-0.528,P<0.01),难治性癫痫预后不良者的丰度明显高于预后良好者(P<0.01)。结论:难治性癫癎患者血清中有特异性质谱峰簇,且与难治性癫癎患者的预后密切相关,提示其可作为难治性癫癎病情和预后评估的重要指标,具有一定的临床指导意义。更多还原

【Abstract】 Objective:To detect the serum proteomic patterns in patients with new-onset and intractable epilepsy and evaluate the clinical value in its prognosis.Methods:20 cases with new-onset and 20 cases with intractable epilepsy were selected from 1653 epileptic patients,classified according to the diagnostic criteria of the International League Against Epilepsy(ILAE) and clinical guideto epilepsy compiled by Chinese Medical Association(CMA) in our out-patient department of neurology from October 2008 to October 2010.The SELDI-TOF-MS technology and WCX2 Protein Chip were used to detect the proteomic patterns of serum of the cases.The correlation analysis of the two groups was carried out between the M/Z values form proteomic fingerprint aflas and the prognoses of intractable epilepsy.Results:A specific mass cluster was discovered in the range of M/Z values:11 100+H-ll 900+H.The abundance of this mass cluster in intractable epileptic patients was significantly higher than that in new-onset epileptic patients(P<0.01).The abundance of this mass cluster was negatively correlated with its outcome in intractable epileptic patients(r= —0.528,P< 0.01).Conclusion:There is a specific mass cluster in the serum proteomic patterns in patients with intractable epilepsy.The abundance of the mass cluster is closely associated with the disease condition and prognosis of patients with intractable epilepsy.更多还原