| Objective: To research on the level of interlukin-1beta ? interlukin-6,? interlukin-8 ?interlukin-10 and tumor necrosis factor-?in serum of adults with refractory epilepsy during interical period,analyze the correlation between positive cytokines with various clinical features of patients,to explore the possible immunological pathogenesis of refractory epilepsy,to provide a theoretical basis for the clinical evaluation?treatment and prognosis determination of refractory epilepy.Methods: The study was divided into three groups,namely refractory epilepsy group(RE group)?drug controlled epilepsy group(CE group)and normal control group(NC group),with 40?20 and 20 cases separately,RE and CE groups were chosen in sequence from epilepsy diagnostic center of neurology department of the First Hospital affiliated Jilin University from October 2016 to December 2017,20 healthy persons were chosen randomly from physical examination center or volunteers during the same period.All patients in both RE and CE groups meet the diagnostic standard of classification which was built up by International League Against Epilepsy(ILAE)in 1981,and meet the definition of epilepsy and epilepsy syndrome in 1989 as well as the lastest definition on refractory epilepsy in 2010.The general and clinical datas of epileptic patients were collected,meanwhile to assess anxiety and depression status through GAD-7?PHQ-9 and NDDIE,and the severity of epilepsy by NHS3.About 5 m L blood of elbow vein were collected in the morning,the serums were collected from EP tubes after centrifugation and stored in-80?refrigerator,then chemiluminescence method was used to determine the level of IL-1 ?-IL-6,IL-8,IL-10,TNF-? in the serum of the three groups.Statistical calculations were performed with SPSS 20.0 software,a p value less than 0.05 was considered statistically significant(?=0.05).Results: 1.The interical cytokine levels in peripheral blood of RE were higher than the other two groups,the positive rates of IL-6 in RE group?CE group and NC group were 25%?5%?5%,the positive rates of IL-8 were 17.5%?15% and 0% separately,it was statistically significant,especially in RE group and CE group.There were no significant difference in the positive rates of IL-10?IL-1?and TNF-?.2.There were 11 cases of IL-6 positive and 49 cases of IL-6 negative in all the 60 epileptic patients.The positive and negative groups had statically significant in areas of duration,seizure frequency at last visit,NHS3 scores and multifocal discharges,Spearman rank correlation analysis showed the level of IL-6 had a positive correlation with the above four clinical features.Among the 40 patients with refractory epilepsy,10 cases were IL-6 positive and 30 cases were IL-6 negative,only duration and seizure frequency had differences between the two groups.3.Among the 60 epileptic petients,14 cases were positive for TNF-?,while 46 cases were negative.The scores of GAD-7 and NDDIE were significantly different in the two groups,the level of TNF-? had a negative correlation with the scores.There were 9 cases of TNF-? positive and 31 cases of TNF-? negative in all the 40 RE patients,the seizure frenquency was different from each other.4.The levels of IL-6 had a positive corrlation with the level of TNF-? in the peripheral blood of refractory epileptic patients,meanwhile,the levels of TNF-? and IL-8?the levels of IL-8 and IL-1 ? had the same results.Conclusions: 1 The interical cytokine levels in peripheral blood of RE increased,especially for IL-6 and IL-8.2 The more frequent seizures,longer duration,higher severity and multifocal discharges during interictal periods,the epileptic patients were more prone to be IL-6 positive,therefore,the positive IL-6 can be a marker to assess the severity of epilepsy,to guide treatment and determine prognosis.3 TNF-? positive epileptic patients are not intend to merge anxiety and depression,to some extent,TNF-? positive may be a protective factor of epilepsy associated with anxiety and depressive disorder. |
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