Schnabel R, Rambeck B, May T W, Jürgens U, Lahl R, Villagrán R
Institute of Neuropathology, Ludwig-Maximilians-University, Munich, Germany.
J Neurol Sci. 1995 Nov;133(1-2):177-82. doi: 10.1016/0022-510x(95)00197-a.
Postmortem concentrations of phenytoin (PHT) and phenobarbital (PB) were determined in 24 specimens of the frontal, temporal, occipital or neocerebellar cortex with different pathological changes and in the serum (total and free) from 11 epileptic patients. The cortical lesions were characterized by various degrees of neuronal loss or necrosis associated with other changes such as proliferated gliocytes, fibre gliosis, Rosenthal fibres or numerous corpora amylacea. According to other investigators neurons are the main binding sites of PHT and PB in rodent brains. The PHT and PB concentrations in 20 cortical lesions from nine patients were not significantly reduced as compared to the data of 46 deceased epileptic control patients. A significantly decreased PB value could only be demonstrated in the temporal specimen of an old scarred infarction with complete demyelination. On the other hand a slight but significant increase of PB was observed in three neocortical samples from a child exhibiting severe brain oedema and thrombosis of the sinuses. The results favour the unspecific binding of PHT and PB to cerebral tissue constituents and do not support the hypothesis of major binding to specific receptors.
测定了24例具有不同病理变化的额叶、颞叶、枕叶或新小脑皮质标本以及11例癫痫患者血清（总血清和游离血清）中苯妥英（PHT）和苯巴比妥（PB）的死后浓度。皮质病变的特征为不同程度的神经元丢失或坏死，并伴有其他变化，如胶质细胞增生、纤维性胶质化、罗森塔尔纤维或大量淀粉样小体。根据其他研究者的观点，神经元是啮齿动物脑中PHT和PB的主要结合位点。与46例已故癫痫对照患者的数据相比，9例患者20个皮质病变中的PHT和PB浓度没有显著降低。仅在一例有完全脱髓鞘的陈旧性瘢痕梗死颞叶标本中，PB值显著降低。另一方面，在一名患有严重脑水肿和静脉窦血栓形成的儿童的三个新皮质样本中，观察到PB有轻微但显著的升高。结果支持PHT和PB与脑组织成分的非特异性结合，不支持与特定受体主要结合的假说。
