【目的】 了解热性惊厥患儿的临床特点及其血浆甘露糖结合凝集素(mannose-binding lectin,MBL)水平在惊厥前后的变化。 【方法】 对2010年8月-2011年7月在本院住院的68例热性惊厥患儿,应用ELISA法检测急性期与恢复期血浆MBL浓度,同时进行临床特点分析。统计分析采用SPSS 11.0。 【结果】 急性期和恢复期MBL平均浓度分别为(595±559) ng/mL和(585±466) ng/mL,二者差异无统计学意义(Z=0.207,P=0.836),急性期与恢复期MBL水平呈线性相关(r=0.809,P<0.01)。其中恢复期MBL血浆浓度<200 ng/mL的病例占29.4%,MBL参与急性应答占全部病例的38.2%。 MBL浓度与CRP浓度无明显相关性(r =0.15,P=0.22)。89.7%的患儿热性惊厥由急性上呼吸道感染诱发,54.1%的患儿惊厥急性期CK-MB增高。 【结论】 惊厥应激对机体血浆MBL水平表达无明显影响。
Abstract
【Objective】 To analyze the clinical characteristics of febrile convulsion (FC) occurred in children and study the mannose-binding lectin (MBL) levels in plasma at both acute and convalescent stages in the case group. 【Methods】 Plasma samples were separated from whole blood which was collected from children with FC at the acute and convalescent stages during August 2010 to July 2011.The MBL concentrations were measured by ELISA method and the SPSS 11.0 software was used in the study. 【Results】 Among all 68 cases,The mean MBL levels were (595±559)ng/mL at acute stage and (585±466)ng/mL in recovery stage,and no significant difference was found between the two groups (Z=0.207,P=0.836).However,there was a significant correlation of the MBL levels between the two stages (r=0.809,P<0.01).29.4% of all individuals had low MBL levels less than 200 ng/mL at convalescent stage.Acute reaction of MBL was observed in 38.2% children with FC.No correlation was found between MBL levels and CRP levels(r =0.15,P=0.22).It was found that 89.7% of the FC children was caused by acute upper respiratory tract infection.The creatine kinase-MB exceeding normal value was found in 54.1% of all individuals. 【Conclusion】 As a whole,convulsion acting as a kind of stress,had no significant effects on the MBL level in vivo.
关键词
热性惊厥 /
甘露糖结合凝集素 /
血浆浓度 /
临床特点 /
儿童
Key words
febrile convulsion /
mannose-binding lectin /
plasma concentration /
clinical characteristics /
children
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参考文献
[1] Takahashi K,Ip WE,Michelow IC,et al.The mannose-binding lectin: a prototypic pattern recognition molecule[J].Current Opinion in Immunology,2006,18:16-23.
[2] Dean MM,Minchinton RM,Heatly S,et al.Mannose binding lectin acute phase activity in patients with severe infection[J].J Clin Immunol,2005,25(4):346-352.
[3] Shinnar S,Glauser TA.Febrile seizures[J].J Child Neurol,2002,17(S):44-52.
[4] Vesterqaard M,Obel C,Henriksen TB,et al.The Danish National Hospital Register is a valuable study base for epidemiologic research in febrile seizures[J].J Clin Epidemiol,2006,59(1):61-66.
[5] Sillanp M,Camfield P,Camfield C,et al.Incidence of febrile seizures in Finland: prospective population-based study[J].Pediatr Neurol,2008,38(6):391-394.
[6] Sugai K.Current management of febrile seizures in Japan:an overview[J].Brain Dev G,2010,32(1):64-70.
[7] Chang WC,White MR,Moyo P,et al.Lack of the pattern recognition molecule mannn-binding lectin increases susceptibility to influenza A virus infection[J].BMC Immunol,2010,11:64-67.
[8] Herpers BL,Endeman H,de Jong BA,et al.Acute-phase responsiveness of mannose-binding lectin in community-acquired pneumonia is highly dependent upon MBL2 genotypes[J].Clin Exp Immunol,2009,156(3):488-494.
[9] Perez-Castellano M,Penaranda M,Payeras A,et al.Mannose-binding lectin does not act as an acute-phase reactant in adults with community-acquired pneumococcal pneumonia[J].Clin Exp Immunol,2006,145(2):228-234.
[10] Akbari R,Mireskandari M,Alizadeh-Navaei R,et al.Measurement of serum levels of mannose-binding lectin in hemodialysis patients: a comparison with healthy individuals[J].Iran J Kidney Dis,2011,5(4):255-259.
[11] 华春珍,俞慧民,尚世强,等.败血病患儿血浆甘露糖结合凝集素表达水平的变化及其基因分型[J].中华传染病杂志,2008,(26):28-32.
[12] Koch A,Melbye M,S rensen P,et al.Acute respiratory tract infections and mannose-binding lectin insufficiency during early childhood[J].JAMA,2001,285(10):1316-1321.
[13] Xi OU,李秋,王墨,等.738例汉族儿童甘露糖结合凝集素血清水平测定[J].中华儿科杂志,2008,46(8):610-612.
[14] 王敏,华春珍,尚世强,等.汉族儿童MBL基因启动子-221位点、外显子Ⅰ区SNP和基因单体型分析[J].现代免疫学,2008,28(2):147-151.
[15] 王墨,李秋,王晓刚,等.血清甘露糖结合凝集素水平及与反复呼吸道感染关系的初步研究[J].中华微生物学和免疫学杂志,2005,25(3):252-254.
基金
浙江省新苗人才计划资助项目(2010R421034)
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