【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:β淀粉樣蛋白（β-amyloid precursor protein，β-APP）是已知的參與阿爾茨海默病機制的關鍵因子。β-APP是否參與難治性癲癇中的病理機制并不清楚。這項研究在于了解β-APP的蛋白在難治性癲癇患者術后顳葉皮質和海馬組織中的表達是否異常。方法:免疫熒光法半定量測定難治性癲癇患者術后顳葉皮質和海馬組織中的β-APP陽性蛋白的熒光值，并應用統計軟件對實驗數據進行單因素方差分析。結果:免疫熒光強度值分析結果顯示β-APP在耐藥性癲癇腦組織中表達較對照組明顯增高且有統計學意義。結論:β-APP在難治性癲癇腦組織中異常增高，增高的β-APP可能參與了難治性癲癇的病理機制。
Objective To analyze the risk factors and prognosis of acute gastrointestinal injury (AGI) early after acute type A aortic dissection (ATAAD) repair, and develop the Nomogram prediction model of AGI. Methods The patients who underwent ATAAD cardiopulmonary bypass surgery in our hospital from 2016 to 2021 were collected and divided into an AGI group and a non-AGI group. The clinical data of the two groups were compared. A Nomogram prediction model was established by using R language. Results A total of 188 patients were enrolled, including 166 males and 22 females, aged 22-70 (49.70±9.96) years. Through multivariate logistic regression analysis, the aortic dissection (AD) risk score, poor perfusion of superior mesenteric artery (SMA), duration of aortic occlusion and intraoperative infusion of red blood cells were the predictors for AGI (P<0.05). There were statistical differences in the ventilator-assisted duration, ICU stay time, liver dysfunction, renal insufficiency, parenteral nutrition, nosocomial infection and death within 30 days after the operation between the two groups (P<0.05). The Nomogram prediction model was established by using the prediction factors, and the C index was 0.888. Through internal verification, the C index was 0.848. The receiver operating characteristic curve was used to evaluate the discrimination of the model, and the area under the curve was 0.888. Conclusion The AD risk score after ATAAD, poor perfusion of SMA, duration of aortic occlusion and intraoperative infusion of red blood cells are independent predictors for AGI. The Nomogram model has good prediction ability.