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目的:探讨高迁移率族蛋白B1(HMGB1)在药物难治性颞叶癫痫患者致痫灶组织中的表达与致痫灶切除术远期预后的关系。方法:选取行致痫灶切除术的药物难治性颞叶癫痫患者80例,术中留取致痫灶组织标本;选取同期行颅内减压术的患者20例为对照,术中留取颅内减压的正常脑组织标本。免疫组化法检测脑组织中HMGB1的表达水平。患者术后随访2 a,分析预后影响因素。结果:癫痫患者致痫灶组织中HMGB1阳性表达率(100%)高于对照组(25%)(P<0.001);患者术前癫痫病程>3 a[OR(95%CI)=3.999(1.535~10.417)]、致痫灶组织中HMGB1强阳性表达[OR(95%CI)=3.483(1.459~8.317)]是药物难治性颞叶癫痫患者术后2 a癫痫控制不佳的独立危险因素。结论:HMGB1可能成为药物难治性颞叶癫痫发病机制、诊疗研究、预后评估的新靶点。
Objective: To investigate the relationship between high mobility group box 1 (HMGB1) expression in epileptogenic tissue of patients with refractory temporal lobe epilepsy and long-term prognosis of epileptic foci. Methods: Eighty patients with intractable temporal lobe epilepsy who underwent epileptogenic resection were enrolled in this study. Epileptogenic tissue samples were collected during operation. Twenty patients undergoing intracranial decompression during the same period were selected as controls. Intracranial decompression of normal brain tissue specimens. Immunohistochemistry was used to detect the expression of HMGB1 in brain tissue. The patients were followed up for 2 years, and the prognostic factors were analyzed. Results: The positive rate of HMGB1 expression in the epileptogenic zone was higher than that in the control group (25%) (P <0.001). The duration of preoperative epilepsy was> 3 a [95% CI = 3.999 ~ 10.417)]. The strong positive expression of HMGB1 in epileptogenic tissue [OR (95% CI) = 3.483 (1.459 ~ 8.317)] was an independent risk factor for poor control of epilepsy in patients with intractable temporal lobe epilepsy . Conclusion: HMGB1 may become a new target for the pathogenesis, diagnosis and treatment of prognosis of drug-refractory temporal lobe epilepsy.