左乙拉西坦对癫痫患者主穹窿蛋白水平及认知功能的影响
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摘要
目的观察左乙拉西坦对癫痫患者外周血主穹窿蛋白(MVP)水平的影响,并探讨其改善认知功能的可能机制。方法收集2013年1月至2016年1月作者医院收治的经左乙拉西坦治疗的癫痫患者120例,应用实时逆转录聚合酶链式反应、免疫蛋白印迹法对患者治疗前及治疗后6、12个月外周血MVP mRNA、MVP蛋白表达水平进行检测,并应用韦氏智力量表对患者的认知功能进行评分。结果用药12个月组患者总智商、语言智商、操作智商及短时视觉记忆评分均较用药前和用药6个月组提高(均P<0.05)。用药6个月和用药12个月组患者外周血MVP mRNA和MVP蛋白表达水平均较用药前降低(均P<0.05),且用药12个月组患者MVP mRNA和MVP蛋白表达水平较用药6个月组降低(均P<0.05)。结论左乙拉西坦可改善癫痫患者认知功能,其机制可能与下调MVP表达有关。
Objective To observe the effect of levetiracetam on the level of peripheral blood main vault protein(MVP)in epileptic patients and explore the possible mechanism of improvement in cognitive function.Methods 120 epilepsy patients treated by levetiracetam in the authors' hospital from January 2013 to January2016 were collected.The expressions of MVP mRNA and MVP protein in the patients were detected by real-time reverse transcriptase polymerase chain reaction and Western blot method at baseline and 6 and 12 months after treatment.The cognitive function of the patients was assessed with the Merriam-Webster intelligence scale.Results The total IQ,Language IQ,Operational IQ and short-term visual memory score estimated 12 months later were higher than baseline and 6-month later(all P<0.05).The expressions of MVP mRNA and MVP protein in the peripheral blood detected 6 months and 12 months later were lower than baseline(all P<0.05),and the expressions of MVP mRNA and MVP protein detected 12 months later were lower than those of 6 months later(all P<0.05).Conclusions Levetiracetam can improve the cognitive function of epileptic patients,and its mechanism may be related to the expression of reduced MVP.
Objective To observe the effect of levetiracetam on the level of peripheral blood main vault protein(MVP)in epileptic patients and explore the possible mechanism of improvement in cognitive function.Methods 120 epilepsy patients treated by levetiracetam in the authors' hospital from January 2013 to January2016 were collected.The expressions of MVP mRNA and MVP protein in the patients were detected by real-time reverse transcriptase polymerase chain reaction and Western blot method at baseline and 6 and 12 months after treatment.The cognitive function of the patients was assessed with the Merriam-Webster intelligence scale.Results The total IQ,Language IQ,Operational IQ and short-term visual memory score estimated 12 months later were higher than baseline and 6-month later(all P<0.05).The expressions of MVP mRNA and MVP protein in the peripheral blood detected 6 months and 12 months later were lower than baseline(all P<0.05),and the expressions of MVP mRNA and MVP protein detected 12 months later were lower than those of 6 months later(all P<0.05).Conclusions Levetiracetam can improve the cognitive function of epileptic patients,and its mechanism may be related to the expression of reduced MVP.
引文
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[2]陈倩.儿童癫痫外科神经心理和神经发育评估[J].中国实用儿科杂志,2016,31(1):22-26.
[3]冒萧萧.耐药性癫痫机制及精准化治疗研究进展[J].国际神经病学神经外科学杂志,2017,44(4):431-435.
[4]徐娟玉,朱乐婷,俞雅珍,等.冰片对小儿难治性癫痫血清和脑脊液丙戊酸钠浓度的影响[J].中国中西医结合杂志,2016,36(9):1138-1140.
[5]Banerjee DA,Sharma D,Srivastava A,et al.Upregulation of breast cancer resistance protein and major vault protein in drug resistant epilepsy[J].Seizure,2017,47:9.
[6]Wang C,Yang L,Zhang J,et al.Higher expression of monocyte chemoattractant protein 1and its receptor in brain tissue of intractable epilepsy patients[J].J Clin Neurosci,2016,28:134-140.
[7]孙明霞,过湘云,徐晓华,等.托吡酯联合丙戊酸治疗对婴儿痉挛症患儿外周血淋巴细胞主穹隆蛋白表达的影响[J].徐州医学院学报,2017,37(8):502-504.
[8]Bordet R,姚庆和.耐药性部分性癫痫的药理学标准[J].世界核心医学期刊文摘:神经病学分册,2005,(2):56-56.
[9]宋婷婷,李丹,黄绍平,等.环氧化酶-2选择性抑制剂塞来昔布对癫癎持续状态大鼠脑内主穹隆蛋白表达的影响[J].中国当代儿科杂志,2016,18(5):440-445.
[10]于金玉,史小宋,李娟.凋亡抑制蛋白XIAP与卵巢癌细胞耐药性[J].国际妇产科学杂志,2016,43(2):161-164.
[11]Ertem DH,Dirican AC,Aydin,et al.Exploring psychiatric comorbidities and their effects on quality of life in patients with temporal lobe epilepsy and juvenile myoclonic epilepsy[J].Psychiat Clin Neurosci,2017,71(4):280-288.
[12]Liu B,Wang T,Wang L,et al.Up-regulation of major vault protein in the frontal cortex of patients with intractable frontal lobe epilepsy[J].J Neurol Sci,2011,308(1-2):88-93.
[13]李龙宽,谢娟,张玲敏,等.左乙拉西坦及奥卡西平对癫痫患儿丙戊酸钠及其代谢产物2-丙基-2-戊烯酸血药浓度的影响[J].中国医院药学杂志,2016,36(1):41-45.
[14]李志鹏,杨昉,胡正,等.左乙拉西坦对伴中央颞区棘波的儿童良性癫痫脑活动影响的静息态功能磁共振成像评价[J].中国临床医学影像杂志,2017,28(10):707-711.
[15]吕志芳,胡海涛,李妍.左乙拉西坦添加疗法治疗青年难治性部分性癫痫疗效及对患者认知功能的影响[J].中国药师,2015,18(4):613-615.
[16]褚旭,孔庆霞,夏敏,等.左乙拉西坦添加治疗青年难治性部分性癫痫患者的效果及对认知功能的影响[J].中国实用神经疾病杂志,2016,8(3):24-25.