【摘要】 目的 探讨单次癫痫发作是否会引起脑损伤。 方法 2007年6月-2009年11月，采用电化学发光法检测癫痫发作后24 h内40例和对照组40例患者血清和脑脊液中神经元特异性烯醇化酶（neuron-specific enolase，NSE）水平，采用ELISA法测定其血清和脑脊液中髓鞘碱性蛋白（myebin bosic protein，MBP）水平。 结果 癫痫组血清和脑脊液中NSE水平明显高于对照组（Plt;0.01）；癫痫组血清MBP水平与对照组比较差异无统计学意义（Pgt;0.05）；癫痫组脑脊液中MBP水平高于对照组（Plt;0.05）。 结论 单次癫痫患者血清和脑脊液中NSE明显升高，脑脊液中MBP升高，提示单次癫痫发作可导致神经元损伤。【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 总结前交通动脉瘤栓塞治疗的经验。 方法 2008年1月－2011年8月，23例前交通动脉瘤患者均在全身麻醉下行动脉瘤内栓塞治疗。其中4例在导丝或导管保护动脉瘤颈情况下行栓塞治疗；1例术中导丝刺破动脉瘤，继续快速填塞至动脉瘤完全栓塞；1例栓塞后弹簧圈突入载瘤动脉，行A1-A2段支架后置入。 结果 23例患者手术技术成功率100%。术后即刻造影，动脉瘤完全栓塞11例，＞90%栓塞8例，＜90%栓塞4例。支架后置入患者术后出现脑梗死，经治疗1个月后康复出院。所有患者临床随访6～24个月，未见再出血。16例患者行全脑血管数字减影血管成像复查，动脉瘤未见复发，其中3例＞90%栓塞、2例＜90%栓塞患者动脉瘤完全闭塞。 结论 弹簧圈栓塞治疗前交通动脉瘤是一种安全、有效的治疗方式。但其技术难度相对较大，需要细致操作。