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目的探讨抗癫药物(AEDs)对婴儿痉挛症(IS)患儿外周血淋巴细胞中多药耐药基因表达产物P-糖蛋白170(P-gp170)表达水平的影响。方法应用流式细胞术检测IS患儿外周血P-gp170的表达,根据其治疗方案不同,分为A组(托吡酯,n=6)、B组(丙戊酸钠+托吡酯,n=9)、C组(丙戊酸钠+氯硝西泮,n=6)、D组(托吡酯+氯硝西泮,n=7)、E组(健康对照组,n=8)。分别于治疗前、治疗后3个月和6个月检测各组患儿外周血P-gp170表达水平。结果 A、B、C、D组在3个时间点P-gp170表达均较E组显著增高(Pa<0.001)。A、B组3个时间点P-gp170表达水平比较差异均无统计学意义,C、D组6个月时P-gp170表达较治疗前及治疗后3个月显著增高(Pa<0.05)。结论 IS患儿P-gp170外周血表达增高。丙戊酸钠和托吡酯对其表达无明显影响,而氯硝西泮长期应用可能增加P-gp170的表达。
Objective To investigate the effect of anti-epileptic drugs (AEDs) on the expression of P-glycoprotein 170 (P-gp170) in peripheral blood lymphocytes of infantile spasms (IS). Methods Flow cytometry was used to detect the expression of P-gp170 in peripheral blood of children with IS, and divided into group A (topiramate, n = 6) and group B (sodium valproate + topiramate, n = 9) , Group C (sodium valproate + clonazepam, n = 6), group D (topiramate + clonazepam, n = 7) and group E (healthy control group, n = 8). Peripheral blood P-gp170 expression levels in each group were detected before treatment, 3 months and 6 months after treatment. Results The expression of P-gp170 in group A, B, C and D at 3 time points was significantly higher than that in E group (Pa <0.001). The expression of P-gp170 in group A and B at 3 time points showed no significant difference. The expression of P-gp170 in group C and D at 6 months was significantly higher than that before treatment and 3 months after treatment (Pa, P <0.05). Conclusion The expression of P-gp170 in peripheral blood of children with IS increased. Sodium valproate and topiramate have no significant effect on its expression, while long-term use of clonazepam may increase the expression of P-gp170.