Lower Plasma Neuropeptide Y Level in Patients with Atypical Febrile Convulsions

非典型熱性痙攣病患具有較低的血漿神經胜肽Y

林龍昌(Lung-Chang Lin) ； 李威德(Wei-Te Lee) ； 陳怡如(I-Ju Chen) ； 楊瑞成(Rei-Cheng Yang)

《The Kaohsiung Journal of Medical Sciences》 26卷1期 (2010/01) Pp. 8-12

摘要

熱性痙攣是小兒科最常見的神經疾患，病患若抽痙超過15分鐘或是在同一次發燒疾患中發生兩次以上的抽痙都被稱為非典型的熱性痙攣，這種非典型的熱性痙攣跟典型的熱性痙攣通常有不一樣的預後。神經胜肽Y是一種內生性的抗痙攣物質，它廣泛的分布於中樞神經系統包含海馬回中，被認為有增加痙攣的閥值而達到減少痙攣發生的功用，我們過去的研究發現非典型熱性痙攣病患有較低的血漿神經胜肽Y濃度，因此假設神經胜肽Y濃度在非典型熱性痙攣扮演一定的角色，為了證明此一假說，我們用放射免疫分析來測量60個熱性痙攣兒童的血漿神經胜肽Y濃度，其中包含14個非典型熱性痙攣及46個典型熱性痙攣，並與56個年齡相近的對照組做比較。結果顯示非典型熱性痙攣兒童的血漿神經胜肽Y濃度顯著的比典型熱性痙攣兒童及對照組低（66.47±19.11pmol/Lvs.88.68±28.50pmol/L及86.82±22.66pmol/L），尤其有兩個非典型熱性痙攣病患血漿神經胜肽Y濃度更低（44.75pmol/L及33.53pmol/L），臨床上，一個痙攣持續一個小時，另一個在同一次的發燒疾患發生三次痙攣，這些結果表示病患若缺乏足夠的神經胜肽Y抑制作用比較容易發生非典型熱性痙攣。

關鍵字

熱性痙攣 ； 神經胜肽Y

並列摘要

Febrile convulsion (FC) is the most common neurological disease in children. Cases with seizures that persist for more than 15 minutes or recurrent seizures within the same febrile illness are considered to be atypical and may have a different prognosis. Neuropeptide Y (NPY), an endogenous anticonvulsant that is widely distributed throughout the central nervous system, including the hippocampus, is known to prevent seizures by increasing the seizure threshold. Based on our previously finding that patients with atypical FC have lower concentrations of NPY, we hypothesized that the concentration of NPY may play a role in the development of atypical FC. To investigate this hypothesis, we used a radioimmunoassay to measure the plasma NPY concentration of 60 children with FC (typical FC, n=46; atypical FC, n=14) and 56 age-matched controls. The atypical FC group had significantly lower concentrations of NPY than children with typical FC and controls (66.47±19.11 pmol/L vs. 88.68±28.50 pmol/L and 86.82±22.66 pmol/L, respectively). Very low NPY levels were found in two patients; one patient (NPY level: 44.75 pmol/L) experienced prolonged seizures lasting for up to 1 hour and the other had recurrent seizures (three seizures) during the same febrile illness (NPY level: 33.53 pmol/L). These results suggest that patients with inadequate NPY inhibitory activity are more susceptible to atypical FC.

並列關鍵字

febrile convulsion ； neuropeptide Y