【摘要】 目的 探討單次癲癇發作是否會引起腦損傷。 方法 2007年6月-2009年11月，采用電化學發光法檢測癲癇發作后24 h內40例和對照組40例患者血清和腦脊液中神經元特異性烯醇化酶（neuron-specific enolase，NSE）水平，采用ELISA法測定其血清和腦脊液中髓鞘堿性蛋白（myebin bosic protein，MBP）水平。 結果 癲癇組血清和腦脊液中NSE水平明顯高于對照組（Plt;0.01）；癲癇組血清MBP水平與對照組比較差異無統計學意義（Pgt;0.05）；癲癇組腦脊液中MBP水平高于對照組（Plt;0.05）。 結論 單次癲癇患者血清和腦脊液中NSE明顯升高，腦脊液中MBP升高，提示單次癲癇發作可導致神經元損傷。【Abstract】 Objective To detect the possibility of brain damage in the epileptic patients after single episodes. Methods The levels of neuron-specific enolase (NSE) in serum and cerebrospinal fluid (CSF) in 40 patients with single episodes within 24 hours after seizures from June 2007 to November 2009 were determined respectively by electrochemiluminescence. Another 40 healthy individuals were enrolled as the control. The levels of myelin basic protein (MBP) were determined by enzyme-linked immunosorbent assay. Results The levels of NSE in the serum and CSF in epileptic group within 24 hours after seizures were significantly higher than those in the control group (Plt;0.01), and the levels of MBP in the serum in the two group didn′t differ much (Pgt;0.05). The levels of MBP in CSF in epileptic group were significantly higher than those in the control group (Plt;0.05). Conclusion After single episodes, the levels of NSE in serum and CSF and the levels of NSE in CSF increase,which suggests that single episodes may lead to neuronal damage.
目的 總結前交通動脈瘤栓塞治療的經驗。 方法 2008年1月－2011年8月，23例前交通動脈瘤患者均在全身麻醉下行動脈瘤內栓塞治療。其中4例在導絲或導管保護動脈瘤頸情況下行栓塞治療；1例術中導絲刺破動脈瘤，繼續快速填塞至動脈瘤完全栓塞；1例栓塞后彈簧圈突入載瘤動脈，行A1-A2段支架后置入。 結果 23例患者手術技術成功率100%。術后即刻造影，動脈瘤完全栓塞11例，＞90%栓塞8例，＜90%栓塞4例。支架后置入患者術后出現腦梗死，經治療1個月后康復出院。所有患者臨床隨訪6～24個月，未見再出血。16例患者行全腦血管數字減影血管成像復查，動脈瘤未見復發，其中3例＞90%栓塞、2例＜90%栓塞患者動脈瘤完全閉塞。 結論 彈簧圈栓塞治療前交通動脈瘤是一種安全、有效的治療方式。但其技術難度相對較大，需要細致操作。