Ko F J, Chiang C H, Liu W J, Chiang W
Department of pediatrics, Kaohsiung Medical College, Taiwan, Republic of China.
Gaoxiong Yi Xue Ke Xue Za Zhi. 1991 Aug;7(8):391-7.
Seventy patients aged from one month to 18 years with seizure disorders were classified into three groups: I. Patients who had hard control seizure attacks even under medication; II. those who had occasional seizure attacks (less than 6 times per year) and III. those who had no seizure attacks after receiving medication for at least one year. Blood samples were taken for somatostatin, substance P, prolactin and vasoactive intestinal peptide (VIP) assays. Lumbar puncture was made in 32 children and CSF samples were also assayed for neuropeptides. Somatostatin levels in serum were significantly elevated in group I and group II (P = 0.05, ANOVA) but not in group III and control group. Similar observations were made in substance P, prolactin and VIP studies. In CSF, the somatostation can better indicate the difference between epileptic and normal children (comparison with group I, P greater than 0.001; with group II, P less than 0.001; even with those who were seizure free after medication, P less than 0.05). In conclusion, the levels of several neuropeptides (somatostatin, substance P. prolactin, VIP) were elevated in children with seizure disorders both in serum and CSF. The present investigation provides a new category for the understanding of the pathogenesis, treatment as well as prognosis of seizure disorders.
70例年龄在1个月至18岁之间的癫痫患者被分为三组：I组为即使在药物治疗下癫痫发作仍难以控制的患者；II组为偶尔发作癫痫（每年少于6次）的患者；III组为接受药物治疗至少一年后无癫痫发作的患者。采集血样进行生长抑素、P物质、催乳素和血管活性肠肽（VIP）检测。对32名儿童进行腰椎穿刺，并对脑脊液样本也进行神经肽检测。I组和II组血清中的生长抑素水平显著升高（P = 0.05，方差分析），但III组和对照组未升高。在P物质、催乳素和VIP研究中也有类似观察结果。在脑脊液中，生长抑素能更好地显示癫痫儿童与正常儿童之间的差异（与I组比较，P>0.001；与II组比较，P<0.001；即使与药物治疗后无癫痫发作的儿童比较，P<0.05）。总之，癫痫患儿血清和脑脊液中几种神经肽（生长抑素、P物质、催乳素、VIP）的水平均升高。本研究为理解癫痫的发病机制、治疗及预后提供了一个新的范畴。
