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目的探讨癫痫发作前后局部脑葡萄糖代谢改变与内分泌变化之间的关系。方法利用ＲＩＡ法对有单叶病灶的７６例癫痫患者进行发作前后血清生长激素（ＧＨ）、泌乳素（ＰＲＬ）、皮质醇（Ｃｏｒ）测定，同时行发作前后脑１８Ｆ脱氧葡萄糖（ＦＤＧ）ＰＥＴ显像，测定病灶局部大脑ＦＤＧ的代谢率。结果癫痫发作后，癫痫灶局部大脑ＦＤＧ代谢相对发作间期均呈相对高代谢，血清ＰＲＬ、ＧＨ、Ｃｏｒ明显升高。癫痫发作后１５ｍｉｎ，８０３％的病例和６８４％的病例血清Ｃｏｒ达到峰值；发作后３０ｍｉｎ，６５８％的病例血清ＧＨ达到峰值；发作后９０ｍｉｎ，大多数病例血清激素水平下降。癫痫发作后血清ＰＲＬ、ＧＨ、Ｃｏｒ升高幅度与癫痫发作类型、发作间期（ＳＦＩ）长短有明显关系，而与癫痫灶位置和癫痫灶局部脑ＦＤＧ摄取率无关。失神性癫痫发作后，大脑局部ＦＤＧ相对摄取率与其他发作类型间差异均无显著性（Ｐ均＞００５），血清ＰＲＬ、Ｃｏｒ不升高或升高不明显；其他发作类型癫痫发作后，ＰＲＬ、Ｃｏｒ显著升高。但癫痫发作后血清ＧＨ变化未表现出发作类型间的差异。ＳＦＩ越短，癫痫发作前血清激素基础水平越低，其中以ＧＨ和Ｃｏｒ最明显，而癫痫发作后血清激素水平的升高幅度越小。?
Objective To investigate the relationship between local cerebral glucose metabolism and endocrine changes before and after epileptic seizures. Methods The serum levels of growth hormone (GH), prolactin (PRL) and cortisol (Cor) were determined before and after the onset of seizures in 76 epileptic patients with single leaf lesions by RIA. The levels of 18F-FDG PET Imaging, determination of local brain lesions FDG metabolic rate. Results After epileptic seizures, FDG metabolism in epileptic foci of local brain showed relative high metabolism, and serum PRL, GH and Cor were significantly increased. Serum Cor peaked in 803% of cases and in 684% of cases at 15min after seizure. Serum GH peaked in 658% of cases at 30min after the onset of seizures. Serum Hormone levels decreased in most cases at 90min after onset of seizures. The level of serum PRL, GH and Cor after epileptic seizure was significantly correlated with the type of seizure and the duration of seizure (SFI), but not with the location of epileptic foci and the local brain FDG uptake in epileptic foci. After deafness epileptic seizures, there was no significant difference in the relative uptake rate of local FDG between the brain and other seizure types (all P> 005), while the serum PRL and Cor did not increase or increase obviously. Other types of seizures , PRL, Cor significantly increased. However, changes in serum GH did not show any difference in seizure types after seizures. The shorter the SFI, the lower the basal level of serum hormones before seizures, with the most obvious GH and Cor, and the lower the level of serum hormones after seizures. ?