- 期刊
Anti-Gt1b and Anti-Gm1 Antibodies Can Increase after Stroke but Neither is Associated with Late Post-Apoplectic Epilepsy
GM1與GT1b抗體可於腦中風後上升但與後期癲癇無關
摘要
腦中風後期併發癲癇之發生機轉目前仍不明瞭。將神經節磷抗體注射到動物的大腦皮質可引發癲癇。部份癲癇病人血清有對抗腦組織的抗體。因此，我們探討神經節磷脂抗體在腦中風後期癲癇中所扮演的角色。首先觀察大範圍之腦梗塞後血中的ant-GT1b (IgM, IgG)與anti-GM1 (IgM, IgG)抗體上升之時間過程。這組病人在腦中風1週內抽血，之後每隔1-2週抽血直到滿2.5月。第二步探討ant-GT1b (IgM, IgG)與anti-GM1 (IgM, IgG)與腦梗塞後期有癲癇(腦梗塞1個月後發生之癲癇)有無關聯。這組病人腦梗塞的部位均在中腦動脈灌流範圍，梗塞大小包括額一顳一頂葉及額葉兩種，抽血時間是腦中風後3個月至3年。這組病人腦中風後須追蹤三年看有無併發癲癇。病人年齡、腦中風後抽血時間、與抗體效價以2-tailed Mann-Whitney U Test作統計分析。
資料顯示第一組8個大範圍腦梗塞病人中有7位ant-GT1b (IgM, IgG) (4人)與anti-GM1 (IgM, IgG)(4人)抗體於數週內達到高峰，2.5至3個月恢復正常。第二組有額一顳一頂葉梗塞患者有21人，其中9人併發癲癇；額葉梗塞患者有9人，其中5人併發癲癇。比較併發癲的額一顳一頂葉梗塞和額葉這兩組患者，他們的年齡、ant-GT1b與anti-GM1抗體效價亦無顯著差異。再將額一顳一頂葉和額葉梗塞合併分析，有和無癲癇這兩組患者之年齡、ant-GT1b與anti-GM1 抗體也無顯著差異。
本文仍首次報告腦中風病人血中的ant-GT1b與anti-GM1 抗體可在數週內升到高峰，2.5至3個月恢復；而3個月後所測的這些抗體效價與腦梗後期併發之癲癇無關。
關鍵字
無資料並列摘要
The role of antiganglioside antibodies (AGAs) in late post-apoplectic epilepsy (LPAE) was studied. Serum AGAs from 8 patients with large lobar infarctions were serially checked for 2.5 months. Sera form another 30 patients with fronto-temporo-parietal (FTP) or Frontal (F) infarction were obtained 3 months to 3 years after a stroke fro AGA analysis. These 30 patients were followed up for 3 years following their strokes to determine if LPAE developed. Results showed that 7/8 patients with large lobar infarction showed increase in either anti-GT1b or anti-GT1b or anti-GM1 (IgM or IgG) within a few weeks, but levels returned to the baseline 2-3 months after stroke. LPAE occurred in 9/21 patients with FTP infarction and 5/9 with F infarction. There was no difference in AGAs among patients with FTP and F infarctions. Pooled data from these 2 groups showed no correlation between AGAs and LPASE. These data document for the first time that anti-GT1b and anti-GM1 antibodies can transiently increase after stroke, but their late titers are not associated with LPAE.