多发性抽动症预后及影响因素的研究

发布时间：2018-06-17 01:54

本文选题：多发性抽动症 + 预后　；参考：《广州中医药大学》2012年硕士论文

【摘要】：目的：本研究通过对2007年-2009年于广东省中医院儿科门诊就诊并确诊为多发性抽动症(又称Tourette综合征,简称TS)的患儿进行调查,探讨多发性抽动症的预后及其影响因素,为TS病情进展评估及防治方案提供依据,有助于巩固治疗疗效,避免病情反复,从而改善预后。方法：对2007年1月-2009年4月于广东省中医院儿科门诊就诊并确诊为多发性抽动症的患儿进行随访,病例均符合美国《精神疾病诊断与统计手册》第四版(DSM-IV)中多发性抽动症的诊断标准,总随访时间为3年。采用统一的调查表,由经过专门培训的调查员以直接询问或电话咨询的方式调查,将性别、发病年龄、其母孕期情况、围生期情况、饮食偏嗜、家庭关系、首发症状、病情严重程度、基础病、共患病(注意缺陷多动障碍、焦虑障碍、强迫障碍等)、精神或神经病家族病史、脑电图、ASO、微量元素水平、病程长短、病情反复频数、医从性等调查内容审核无误后录入计算机采用spss软件包建立数据库。用SPSS17.0软件,计量资料方差齐性者用t检验,方差不齐者、等级资料用秩和检验,计数资料用卡方检验,用单因素非条件Logistic回归分析方法筛选危险因素,将选出的有意义的因素再引入二分类非条件Logistic回归分析。结果：随访病例数166例(男135例,女31例),失访40例。其中未愈62例(37.3%),痊愈、显效加好转104例(62.7%)。单因素非条件Logistic回归分析显示有显著意义的变量为父亲文化程度、父亲不良嗜好、精神或神经病家族病史、反复呼吸道感染、注意缺陷多动障碍、病情严重程度、病情反复频数7个因素(P0.05)；再将7个因素引入二分类非条件Logistic回归分析,精神或神经病家族病史、反复呼吸道感染、注意缺陷多动障碍、病情严重程度、病情反复频数5个因素进入最终回归方程(P0.05),其OR值与95%C1分别为：2.363、1.003-5.568,2.510、1.164-5.412,2.425、1.102-5.336,30.594、2.182-429.032,4.957、1.149-21.390。结论： TS患儿的预后与精神或神经病家族病史、反复呼吸道感染、注意缺陷多动障碍、病情严重程度、病情反复频数等影响因素相关。
[Abstract]:Objective: to investigate the children with Tourette syndrome (TSS) who were diagnosed as Tourette syndrome (TS) in the pediatric outpatient clinic of Guangdong Provincial Hospital of traditional Chinese Medicine from 2007 to 2009. To explore the prognosis of multiple tic disorder and its influencing factors, to provide the basis for the evaluation of disease progression and prevention and treatment of TS, to help consolidate the therapeutic effect, to avoid the recurrence of the disease, and to improve the prognosis. Methods: from January 2007 to April 2009, the children who were diagnosed as multiple tic syndrome in pediatrics clinic of Guangdong Provincial traditional Chinese Medicine Hospital were followed up. All cases were in accordance with the diagnostic criteria of multiple tic disorder in the fourth edition of DSM-IV. the total follow-up time was 3 years. A uniform questionnaire was used to investigate the sex, age of onset, maternal pregnancy, perinatal period, diet preference, family relationship, first symptom by means of direct inquiry or telephone consultation by specially trained investigators. Severity of illness, basic disease, co-prevalence (attention deficit hyperactivity disorder, anxiety disorder, obsessive-compulsive disorder, family history of mental or neuropathy, electroencephalogram (EEG) ASO, trace element level, duration of disease, recurrence of disease, etc.) After checking the contents of the investigation, the computer was used to establish the database with spss software package. SPSS 17.0 software was used to analyze the risk factors by t test, rank sum test, chi-square test and univariate conditional logistic regression analysis. The selected significant factors were introduced into the two-classification non-conditional logistic regression analysis. Results: 166 cases (135 males, 31 females) were followed up. 62 cases were cured, 104 cases improved significantly. Univariate conditional logistic regression analysis showed that the significant variables were father's education, father's bad habits, family history of mental or neuropathy, recurrent respiratory tract infection, attention deficit hyperactivity disorder and severity of the disease. Seven factors of recurrent frequency of the disease (P0.05N) were introduced into the two-classification non-conditional logistic regression analysis, the family history of mental or neuropathy, recurrent respiratory tract infection, attention deficit hyperactivity disorder, and severity of the disease. The OR and 95 of the five factors entered the final regression equation (P0.05) were respectively: 1: 2.363C1.003-5.5682.101-1.164-5.412O2.4251.102-5.336U 30.5942.182-429.032v 4.959-21.390. the odds ratio (OR) was 1.363N 1.003-5.5681.164-5.412C 1.102-5.336U 30.594U 2.182-429.032n 4.959-21.390. Conclusion: the prognosis of TS children is related to the family history of psychosis or neuropathy, recurrent respiratory tract infection, attention deficit hyperactivity disorder, severity of illness, recurrence frequency of disease and so on.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.94

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