摘要目的 探讨癫痫患儿外周血B淋巴细胞CD20表达的变化与癫痫发作的关系.方法 应用流式细胞仪测定本院2008年1月至2010年12月就诊的620例儿童癫痫患者外周血B淋巴细胞CD20的表达,并与健康对照组(n=36)进行比较.同时分析96例儿童癫痫患者(症状性癫痫患者37例,特发性癫痫患者59例)应用静脉注射免疫球蛋白(IVIG)治疗前后的B淋巴细胞CD20表达的改变,并评价IVIG治疗各型癫痫的有效率.结果 癫痫儿童外周血B淋巴细胞CD20+比例较健康对照组明显升高[(21.50±8.41)％比(16.13±4.19)％,P＜0.05].96例儿童癫痫患者经IVIG治疗6个月后外周血B淋巴细胞CD20+细胞比例较治疗前下降[(16.74±5.12)％比(21.61±8.03)％,P＜0.05].IVIG治疗癫痫总体有效率为76.04％(73/96),症状性癫痫治疗有效率为86.49％ (32/37),特发性癫痫治疗有效率为69.49％(41/59).结论 儿童癫痫患者存在B淋巴细胞功能异常,IVIG治疗能改善癫痫患儿的细胞免疫功能.

abstractsObjective To investigate the association between the CD20 expression in peripheral B lymphocyte in children with epilepsy and onset of the disease.Methods The expression of peripheral B lymphocyte CD20 was detected by flow cytometry in 620 children with epilepsy who visited our hospital between January 2008 and December 2010,and was compared with the findings from 36 healthy controls.Moreover,96 epileptic children (including 37 cases of symptomatic epilepsy and 59 of idiopathic epilepsy)were treated with intravenous immunoglobulin (IVIG).The change in peripheral B lymphocyte CD20expression from baseline among these children were analyzed and used in evaluation for therapeutic effects of IVIG in epilepsy.Results Level of peripheral B lymphocyte CD20 expression increased remarkably in epileptic children compared with healthy controls [ (21.50±8.41)％ vs (16.13±4.19％),P＜0.05].After 6months of IVIG therapy,the percentage of CD20+ cells in the 96 epileptic children was lowered as compared with baseline [ (6.74±5.12)％ vs (21.61±8.03)％,P＜0.05].The rate of response with IVIG therapy was 76.04％ (73/96) in overall epilepsy,86.49％ (32/37) in symptomatic epilepsy,and 69.49％ in idiopathic epilepsy.Conclusion B lymphocyte dysfunction exists in children with epilepsy and IVIG treatment can improve cellular immune dysfunction.