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目的探讨热性惊厥(FC)患儿血清脑型肌酸激酶同工酶(CK-BB)和血浆内皮素(ET)水平的变化及其两者结合脑电图(EEG)检查与脑损伤的关系。方法将2005-08—2006-12在潍坊医学院儿科就诊的52例FC患儿作为FC组,健康儿童28例作为正常对照组,分别进行血清CK-BB和血浆ET的测定及EEG检查,CK-BB采用比色法测定,ET采用放射免疫法测定。结果FC患儿血液中CK-BB和ET水平明显高于正常对照组(P均<0.01);单纯热惊厥(SFC)组CK-BB和ET的浓度与正常对照组比较差异无显著性(P>0.05);复杂热惊厥(CFC)组与正常对照组和SFC组比较差异均具有显著性(P均<0.01)。CFC组血清CK-BB与血浆ET呈正相关(r=0.652,P<0.01)。FC患儿惊厥发作后第1天EEG异常率为80.77%,其中SFC组78.12%,CFC组85.00%,差异无显著性(P>0.05);第14天为32.69%,SFC组仅18.75%,CFC组则55.00%,差异具有显著性(P<0.01)。结论CK-BB和ET水平与脑损伤的程度密切相关,CK-BB和ET含量越高脑损伤程度越严重。热性惊厥后及时检测CK-BB和ET,并结合脑电图检查对判断脑损伤程度及预后有重要价值。
Objective To investigate the changes of serum brain-type creatine kinase (CK-BB) and plasma endothelin (ET) levels in children with febrile seizures (FC) and their association with EEG and brain injury relationship. Methods 52 cases of FC pediatric pediatric patients treated in Weifang Medical College from August 2005 to December 2006 were selected as the FC group and 28 healthy children as the normal control group. Serum CK-BB, plasma ET, EEG, -BB was measured by colorimetric method, and ET was determined by radioimmunoassay. Results The levels of CK-BB and ET in the blood of children with FC were significantly higher than those in the normal control group (all P <0.01). There were no significant differences in CK-BB and ET concentrations between the two groups > 0.05). There was significant difference between the group of complicated febrile seizures (CFC) and normal control group and SFC group (all P <0.01). Serum CK-BB in CFC group was positively correlated with plasma ET (r = 0.652, P <0.01). The frequency of abnormal EEG in the FC group was 80.77% on the first day after the seizure, in which 78.12% in the SFC group and 85.00% in the CFC group were not significantly different (P> 0.05), 32.69% in the 14th day and 18.75% in the SFC group, CFC group was 55.00%, the difference was significant (P <0.01). Conclusion The levels of CK-BB and ET are closely related to the degree of brain injury. The higher the levels of CK-BB and ET, the more severe the brain injury. Post-febrile seizures and timely detection of CK-BB and ET, combined with EEG examination to determine the extent of brain injury and prognosis of great value.