發(fā)布時(shí)間：2018-06-17 01:54

  本文選題：多發(fā)性抽動(dòng)癥 + 預(yù)后��； 參考：《廣州中醫(yī)藥大學(xué)》2012年碩士論文

【摘要】：目的： 本研究通過(guò)對(duì)2007年-2009年于廣東省中醫(yī)院兒科門(mén)診就診并確診為多發(fā)性抽動(dòng)癥(又稱(chēng)Tourette綜合征,簡(jiǎn)稱(chēng)TS)的患兒進(jìn)行調(diào)查,探討多發(fā)性抽動(dòng)癥的預(yù)后及其影響因素,為T(mén)S病情進(jìn)展評(píng)估及防治方案提供依據(jù),有助于鞏固治療療效,避免病情反復(fù),從而改善預(yù)后。 方法： 對(duì)2007年1月-2009年4月于廣東省中醫(yī)院兒科門(mén)診就診并確診為多發(fā)性抽動(dòng)癥的患兒進(jìn)行隨訪(fǎng),病例均符合美國(guó)《精神疾病診斷與統(tǒng)計(jì)手冊(cè)》第四版(DSM-IV)中多發(fā)性抽動(dòng)癥的診斷標(biāo)準(zhǔn),總隨訪(fǎng)時(shí)間為3年。采用統(tǒng)一的調(diào)查表,由經(jīng)過(guò)專(zhuān)門(mén)培訓(xùn)的調(diào)查員以直接詢(xún)問(wèn)或電話(huà)咨詢(xún)的方式調(diào)查,將性別、發(fā)病年齡、其母孕期情況、圍生期情況、飲食偏嗜、家庭關(guān)系、首發(fā)癥狀、病情嚴(yán)重程度、基礎(chǔ)病、共患病(注意缺陷多動(dòng)障礙、焦慮障礙、強(qiáng)迫障礙等)、精神或神經(jīng)病家族病史、腦電圖、ASO、微量元素水平、病程長(zhǎng)短、病情反復(fù)頻數(shù)、醫(yī)從性等調(diào)查內(nèi)容審核無(wú)誤后錄入計(jì)算機(jī)采用spss軟件包建立數(shù)據(jù)庫(kù)。用SPSS17.0軟件,計(jì)量資料方差齊性者用t檢驗(yàn),方差不齊者、等級(jí)資料用秩和檢驗(yàn),計(jì)數(shù)資料用卡方檢驗(yàn),用單因素非條件Logistic回歸分析方法篩選危險(xiǎn)因素,將選出的有意義的因素再引入二分類(lèi)非條件Logistic回歸分析。 結(jié)果： 隨訪(fǎng)病例數(shù)166例(男135例,女31例),失訪(fǎng)40例。其中未愈62例(37.3%),痊愈、顯效加好轉(zhuǎn)104例(62.7%)。單因素非條件Logistic回歸分析顯示有顯著意義的變量為父親文化程度、父親不良嗜好、精神或神經(jīng)病家族病史、反復(fù)呼吸道感染、注意缺陷多動(dòng)障礙、病情嚴(yán)重程度、病情反復(fù)頻數(shù)7個(gè)因素(P0.05)；再將7個(gè)因素引入二分類(lèi)非條件Logistic回歸分析,精神或神經(jīng)病家族病史、反復(fù)呼吸道感染、注意缺陷多動(dòng)障礙、病情嚴(yán)重程度、病情反復(fù)頻數(shù)5個(gè)因素進(jìn)入最終回歸方程(P0.05),其OR值與95%C1分別為：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。 結(jié)論： TS患兒的預(yù)后與精神或神經(jīng)病家族病史、反復(fù)呼吸道感染、注意缺陷多動(dòng)障礙、病情嚴(yán)重程度、病情反復(fù)頻數(shù)等影響因素相關(guān)。
[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.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R749.94

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