抽动障碍患儿血清S100B蛋白、NSE水平及临床意义

发布时间：2018-07-05 10:09

本文选题：抽动障碍 + S100B蛋白　；参考：《福建医科大学》2015年硕士论文

【摘要】：目的1.通过研究TD患儿与健康儿童血清S100B蛋白、NSE水平,探讨TD患儿是否存在脑损伤。2.通过研究TD患儿应用阿立哌唑治疗前后血清S100B蛋白、NSE水平,探讨临床症状改善后脑损伤是否也改善。方法1.依据DSM-IV-TR的TD诊断标准为纳入标准,选取福建省立医院儿科门诊中符合要求的初诊病人入组,其中TD组63人,并选取门诊体检的健康儿童20例作为对照组。2.采集所有入组儿童初次就诊时及TD组治疗后的静脉血各4ml,离心后收集上层血清,低温保存至检测。S100B蛋白懫用酶联免疫吸附试验检测;NSE懫用免疫化学发光法检测。3.TD组患儿均使用阿立哌唑治疗,观察疗程12周,临床疗效采用《耶鲁综合抽动严重程度量表》进行评定,并用《不良反应量表》评定不良反应。4.实验数椐的统计分析采用SPSS19.0软件完成。结果1.对照组健康儿童和TD组患儿血清S100B蛋白浓度与年龄之间均无显著相关性(r=-0.069,P0.05;r=-0.03,P0.05)。2.TD组治疗前患儿较对照组健康儿童血清S100B蛋白、NSE浓度均明显升高(P0.01;P0.01),差异均具有统计学意义。3.TD组治疗前患儿血清S100B蛋白、NSE浓度与治疗前YGTSS评分之间均无显著相关性(r=0.222,P0.05;r=-0.016,P0.05)。4.TD组患儿经过阿立哌唑治疗12周后,血清S100B蛋白、NSE浓度较治疗前均明显降低(P0.01;P0.05),差异均具有统计学意义。5.TD组患儿经耶鲁综合抽动严重程度量表(YGTSS)测评后,结果显示:1例治愈,47例显效,2例有效,13例无效,总有效率为80%。主要不良反应有嗜睡、头痛、头晕,无其它不良反应,不良反应率为9.52%。结论1.健康儿童、TD患儿血清S100B蛋白浓度不会随着年龄的增加而改变。2.TD组患儿较对照组儿童血清S100B蛋白、NSE浓度均明显升高,说明TD患儿存在脑损伤。3.TD患儿脑损伤程度与其抽动严重程度无关。4.TD患儿经治疗后症状改善,血清S100B蛋白、NSE浓度较治疗前均有明显降低,说明TD患儿经治疗后脑损伤有所改善。5.TD患儿在使用小剂量(2.5mg/d~10mg/d)阿立哌唑后症状改善,且S100B蛋白及NSE的浓度较前明显降低,说明阿立哌唑对治疗TD患儿有一定的疗效,且具有安全性,可作为其药物治疗的新选择。
[Abstract]:Objective 1. By studying the serum S100B protein and NSE levels in children with TD and healthy children, we investigated whether there were brain injury. 2. By studying the serum S100B protein NSE level of children with TD before and after treatment with aripiprazole, we investigated whether the brain injury could be improved after clinical symptoms were improved. Method 1. According to the TD diagnostic criteria of DSM-IV-TR, the newly diagnosed patients in the pediatric outpatient department of Fujian Provincial Hospital were selected as the inclusion criteria, including 63 patients in the TD group, and 20 healthy children in the outpatient examination as the control group. The venous blood samples were collected from all the children at first visit and after treatment in TD group. The upper serum was collected after centrifugation. After cryopreservation to detection of S100B protein, NSE was detected by enzyme-linked immunosorbent assay (Elisa) and immunochemiluminescent assay was used. 3. All the children in group TD were treated with aripiprazole for 12 weeks. The clinical efficacy was evaluated by Yale Comprehensive tic severity scale, and adverse reaction was assessed by adverse reaction scale. According to the experimental data, SPSS 19.0 software was used to complete the statistical analysis. Result 1. There was no significant correlation between serum S100B protein concentration and age in healthy children in control group and TD group (P 0.05). 2. The serum S100B protein NSE concentration in TD group was significantly higher than that in healthy children before treatment (P0.01, P0.01). 3. There was no significant correlation between serum S100B protein NSE concentration and YGTSS score before treatment in TD group (r = 0.222) (P 0.05). 4. After 12 weeks of treatment with aripiprazole, there was no significant correlation between serum S100B protein NSE and YGTSS score in TD group. The serum S100B protein NSE concentration was significantly lower than that before treatment (P0.01P 0.05). The difference was statistically significant. 5. After the Yale Comprehensive tic severity scale (YGTSS) was measured, the results showed that 1 case of 1 case was cured and 2 cases were effective and 13 cases were ineffective, and the total effective rate was 80%. The main adverse reactions were somnolence, headache, dizziness, no other adverse reactions, and the adverse reaction rate was 9.52%. Conclusion 1. The serum S100B protein concentration in healthy children with TD did not change with age. 2. The serum S100B protein NSE levels in TD group were significantly higher than those in control group. The results showed that the degree of brain injury was not related to the severity of twitch in children with TD. 4. After treatment, the symptoms of children with TD were improved, and the concentration of serum S100B protein NSE was significantly lower than that before treatment. 5. The symptoms of patients with TD were improved after treatment with low dose (2.5mg/d~10mg/d) aripiprazole, and the concentrations of S100B protein and NSE were significantly lower than before, indicating that aripiprazole has a certain curative effect on children with TD. It is safe and can be used as a new choice of drug therapy.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R749.94

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