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目的观察耐药性颞叶内侧癫痫硬化海马中有关耐药基因蛋白的表达并探讨其临床意义。方法对经手术治疗取自16例颞叶内侧癫痫的硬化海马标本进行免疫组化染色观察p-糖蛋白170(p-gp170)、谷胱甘肽硫转移酶-π(GST-π)、拓扑酶II(TOPII)、胸苷合成酶(TS)及O-6-甲基鸟嘌呤-DNA-甲基转移酶(MGMT)的表达。结果p-gp170和GST-π在硬化海马组织中神经细胞、血管内皮细胞及胶质细胞均有表达,而以血管内皮细胞和胶质细胞阳性表达尤为突出。TOPII、TS和MGMG在硬化海马中无明显阳性表达。结论长期应用抗癫痫药物可能诱导p-gp170和GST-π表达增强,促进抗癫痫药物的排出与代谢,引起耐药。TOPII、TS和MGMG可能与癫痫耐药机制无关。
Objective To investigate the expression of drug-resistant genes in the hippocampus of drug-resistant temporal lobe medial epilepsy and its clinical significance. Methods Immunohistochemistry was used to detect the expression of p-gp170, GST-π in the hardened hippocampus specimens from 16 cases of medial temporal lobe epilepsy. The topography Enzyme II (TOPII), thymidine synthase (TS) and O-6-methylguanine-DNA-methyltransferase (MGMT). Results Both p-gp170 and GST-π were expressed in nerve cells, vascular endothelial cells and glial cells in the sciatic hippocampus, especially in the positive expression of vascular endothelial cells and glial cells. TOPII, TS and MGMG in the sclerosis hippocampus no significant positive expression. Conclusion Long-term use of antiepileptic drugs may induce the expression of p-gp170 and GST-π to be enhanced, and promote the excretion and metabolism of antiepileptic drugs and cause drug resistance. TOPII, TS and MGMG may not be related to the mechanism of epilepsy resistance.