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[强直阵挛性癫痫发作患者尿液中儿茶酚胺的分泌]

[Secretion of catecholamines in urine of patients with tonic-clonic epileptic seizures].

作者信息

Kapustecki J, Rościszewska D, Pierzchała K

机构信息

Katedry Kliniki Neurologii Slaskiej Akademii Medycznej w Katowicach.

出版信息

Wiad Lek. 2000;53(9-10):499-506.

Abstract

UNLABELLED

Epileptic seizures are concerned with temporary neuronal activation of adrenal medulla, manifested by increase of adrenaline and noradrenaline concentration in plasma and clinical symptoms as, among others, an increase in blood pressure, tachycardia and temporary hyperglycaemia. This adrenergical activation may be probably due to reactivity changes in adrenal-sympathetic system in patients with epilepsy also in interseizure periods.

AIM

Evaluation of adrenaline, noradrenaline and dopamine excretion in 24-hour period urine collection in epileptic patients and examination, if there is a correlation between epilepsy clinical picture and catecholamines urine elimination.

MATERIAL

32 epileptic patients (16 women, 16 men) in mean age 31.1 +/- 7.1 and 29 healthy age-matched subjects in control. The age of falling ill, disease duration, etiology, family history, type and frequency of seizures, results of neurological and EEG examinations and the applied treatment, have all been taken into account in epilepsy clinical picture.

METHOD

Daily urine collection was performed on a day-off, and time lapse since the last epileptic seizure was at least 48 hours. Quantitative determination of adrenaline, noradrenaline and dopamine in urine was performed by fluorimetric method. Differences among the obtained values were compared by t-Student's test, additionally, correlation coefficient was calculated.

RESULTS

Significantly lower mean quantities of dopamine excreted within 24 hours in the whole group of epileptic patients and no significant differences in adrenaline and noradrenaline excretion were found, in relation to control group. Differences in catecholamines excretion in some cases occurred, in correlation with epilepsy clinical picture (onset of epilepsy, results of neurological and EEG examination, phenytoin treatment).

CONCLUSIONS

Obtained results suggest the reactivity disturbance of dopamine-noradrenaline-adrenaline system in the epilepsy course. It may result in changes of catecholamines, especially dopamine, excretion with urine.

摘要

未标记

癫痫发作与肾上腺髓质的短暂神经元激活有关,表现为血浆中肾上腺素和去甲肾上腺素浓度升高以及临床症状,如血压升高、心动过速和短暂性高血糖等。这种肾上腺素能激活可能是由于癫痫患者在发作间期肾上腺 - 交感神经系统的反应性变化所致。

目的

评估癫痫患者24小时尿液中肾上腺素、去甲肾上腺素和多巴胺的排泄情况,并检查癫痫临床表现与儿茶酚胺尿排泄之间是否存在相关性。

材料

32例癫痫患者(16名女性,16名男性),平均年龄31.1±7.1岁,以及29名年龄匹配的健康对照者。癫痫临床表现考虑了发病年龄、病程、病因、家族史、发作类型和频率、神经学和脑电图检查结果以及所应用的治疗方法。

方法

在休息日进行每日尿液收集,自上次癫痫发作后的时间间隔至少为48小时。采用荧光法对尿液中的肾上腺素、去甲肾上腺素和多巴胺进行定量测定。通过t检验比较所得值之间的差异,此外还计算了相关系数。

结果

与对照组相比,癫痫患者全组24小时内多巴胺排泄的平均量显著降低,而肾上腺素和去甲肾上腺素排泄无显著差异。在某些情况下,儿茶酚胺排泄的差异与癫痫临床表现(癫痫发作起始、神经学和脑电图检查结果、苯妥英治疗)相关。

结论

所得结果提示在癫痫病程中多巴胺 - 去甲肾上腺素 - 肾上腺素系统的反应性紊乱。这可能导致儿茶酚胺,尤其是多巴胺,随尿液排泄的变化。

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