【摘要】 目的分析甲泼尼龙对难治性癫痫患儿免疫细胞分化及高迁移率族蛋白B1(high mobility group protein B1,HMGB1)、神经元特异性烯醇化酶(neuron-specificenolase,NSE)表达的影响。方法将连云港市第一人民医院2015年1月—2019年6月间收治的126例难治性癫痫患儿随机分为观察组及对照组;对照组采用传统治疗联合生酮饮食方案进行治疗,观察组在对照组基础上加用甲泼尼龙进行治疗;治疗后6个月时对患儿临床疗效进行评估,治疗前及随访6个月时检测血中HMGB1、NSE、Th1、Th17、CD4~+CD25-和CD4~+CD25~+T细胞水平。结果观察组治疗总有效率为98.41%,显著高于对照组(P<0.05);治疗后观察组血中HMGB1及NSE水平明显低于对照组,且差异有统计学意义(P<0.05);观察组血中Th1、Th17水平均明显低于对照组,CD4~+CD25-T、CD4~+CD25~+T水平明显高于对照组,且差异存统计学意义(P<0.05)。结论采用生酮饮食联合甲泼尼龙对难治性癫痫患儿治疗后显著改善血中免疫细胞分化水平,并降低血中HMGB1、NSE表达。更多还原

【Abstract】 Objective To analyze the effect of methylprednisolone on immune cell differentiation and expressions of HMGB1 and NSE in children with refractory epilepsy. Methods One hundred and twenty-six children with refractory epilepsy admitted to our hospital between January 2015 and June 2019 were randomly divided into the observation group and control group. The control group received traditional treatment combined with a ketogenic diet, while the observation group was additionally given methylprednisolone.The clinical efficacy of the patients was evaluated six months after treatment. Serum levels of HMGB1, NSE, Th1, Th17, CD4~+CD25-and CD4~+CD25~+ T were detected before treatment and after 6 months of follow-up. Results The total effective rate of treatment in the observation group was 98.41%, which was significantly higher than that in the control group(P<0.05). After treatment, the levels of HMGB1 and NSE in the observation group were significantly lower than those in the control group, and the difference was statistically significant(P<0.05). The serum levels of Th1 and Th17 in the observation group were significantly lower than those in the control group, but the levels of CD4~+CD25-T, CD4~+CD25~+T were significantly higher, and the difference was of statistical significance(P<0.05). Conclusion Treatment of children with refractory epilepsy with a ketogenic diet combined with methylprednisolone can significantly improve the serum level of immune cell differentiation while reducing the serum expressions of HMGB1 and NSE.更多还原