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目的研究免疫球蛋白、胸腺肽等免疫调节剂辅助治疗难治性癫痫的临床疗效,观察免疫调节剂对难治性癫痫患儿免疫功能的影响,探讨通过免疫调控辅助治疗难治性癫痫的可行性。方法70例难治性癫痫患儿随机分为三组,30例仅采用抗癫痫药物治疗(对照组),20例抗癫痫药物加免疫球蛋白治疗(免疫球蛋白组),20例抗癫痫药物加胸腺肽治疗(胸腺肽组)。血清IgA、IgG、IgM、C3测定采用单向免疫扩散法。CD3、CD4、CD8等T细胞亚群测定采用桥联酶标法。结果免疫球蛋白组(55.00%)、胸腺肽组(52.50%)癫痫控制总有效率(Ⅰ满意+Ⅱ显著改善+Ⅲ良好)皆显著高于对照组(8.33%)。对照组治疗前后比较:患儿IgA、IgG、IgM、C3、CD3、CD4、CD8、CD4/CD8等各项免疫指标差异皆无显著性意义。免疫球蛋白组、胸腺肽组治疗前后比较:患儿IgA、IgG升高,IgM、C3无明显差异,CD3、CD4、CD4/CD8升高,CD8降低。结论免疫球蛋白、胸腺肽使难治性癫痫患儿癫痫发作控制总有效率显著提高;免疫球蛋白、胸腺肽能够显著改善难治性癫痫患儿免疫功能。
Objective To study the clinical efficacy of adjuvant immunomodulatory agents such as immunoglobulin and thymosin in the treatment of refractory epilepsy and to observe the effect of immunomodulatory agents on immune function in children with refractory epilepsy and to explore the feasibility of adjuvant therapy for refractory epilepsy . Methods Seventy patients with intractable epilepsy were randomly divided into three groups: 30 cases were treated with antiepileptic drugs only (control group), 20 cases were treated with antiepileptic drugs plus immunoglobulin (immunoglobulin group), 20 cases with antiepileptic drugs Plus thymosin treatment (thymosin group). Serum IgA, IgG, IgM, C3 assay using one-way immunodiffusion. CD3, CD4, CD8 and other T cell subsets were determined by the method of enzyme linked immunosorbent assay. Results The total effective rate of control of epilepsy (Ⅰ satisfaction + Ⅱ significantly improved + Ⅲ good) in immunoglobulin group (55.00%) and thymosin group (52.50%) were significantly higher than those in control group (8.33%). There was no significant difference in the immunological indexes such as IgA, IgG, IgM, C3, CD3, CD4, CD8, CD4 / CD8 in the control group before and after treatment. Immunoglobulin, thymosin group before and after treatment: children with IgA, IgG increased, IgM, C3 no significant difference in CD3, CD4, CD4 / CD8 increased CD8 decreased. Conclusion Immunoglobulin and thymosin significantly improve the total effective rate of seizure control in children with refractory epilepsy. Immunoglobulin and thymosin can significantly improve immune function in children with refractory epilepsy.