發(fā)布時間：2018-07-05 10:09

  本文選題：抽動障礙 + S100B蛋白　； 參考：《福建醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的1.通過研究TD患兒與健康兒童血清S100B蛋白、NSE水平,探討TD患兒是否存在腦損傷。2.通過研究TD患兒應(yīng)用阿立哌唑治療前后血清S100B蛋白、NSE水平,探討臨床癥狀改善后腦損傷是否也改善。方法1.依據(jù)DSM-IV-TR的TD診斷標準為納入標準,選取福建省立醫(yī)院兒科門診中符合要求的初診病人入組,其中TD組63人,并選取門診體檢的健康兒童20例作為對照組。2.采集所有入組兒童初次就診時及TD組治療后的靜脈血各4ml,離心后收集上層血清,低溫保存至檢測。S100B蛋白懫用酶聯(lián)免疫吸附試驗檢測;NSE懫用免疫化學(xué)發(fā)光法檢測。3.TD組患兒均使用阿立哌唑治療,觀察療程12周,臨床療效采用《耶魯綜合抽動嚴重程度量表》進行評定,并用《不良反應(yīng)量表》評定不良反應(yīng)。4.實驗數(shù)椐的統(tǒng)計分析采用SPSS19.0軟件完成。結(jié)果1.對照組健康兒童和TD組患兒血清S100B蛋白濃度與年齡之間均無顯著相關(guān)性(r=-0.069,P0.05;r=-0.03,P0.05)。2.TD組治療前患兒較對照組健康兒童血清S100B蛋白、NSE濃度均明顯升高(P0.01;P0.01),差異均具有統(tǒng)計學(xué)意義。3.TD組治療前患兒血清S100B蛋白、NSE濃度與治療前YGTSS評分之間均無顯著相關(guān)性(r=0.222,P0.05;r=-0.016,P0.05)。4.TD組患兒經(jīng)過阿立哌唑治療12周后,血清S100B蛋白、NSE濃度較治療前均明顯降低(P0.01;P0.05),差異均具有統(tǒng)計學(xué)意義。5.TD組患兒經(jīng)耶魯綜合抽動嚴重程度量表(YGTSS)測評后,結(jié)果顯示:1例治愈,47例顯效,2例有效,13例無效,總有效率為80%。主要不良反應(yīng)有嗜睡、頭痛、頭暈,無其它不良反應(yīng),不良反應(yīng)率為9.52%。結(jié)論1.健康兒童、TD患兒血清S100B蛋白濃度不會隨著年齡的增加而改變。2.TD組患兒較對照組兒童血清S100B蛋白、NSE濃度均明顯升高,說明TD患兒存在腦損傷。3.TD患兒腦損傷程度與其抽動嚴重程度無關(guān)。4.TD患兒經(jīng)治療后癥狀改善,血清S100B蛋白、NSE濃度較治療前均有明顯降低,說明TD患兒經(jīng)治療后腦損傷有所改善。5.TD患兒在使用小劑量(2.5mg/d~10mg/d)阿立哌唑后癥狀改善,且S100B蛋白及NSE的濃度較前明顯降低,說明阿立哌唑?qū)χ委烼D患兒有一定的療效,且具有安全性,可作為其藥物治療的新選擇。
[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.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R749.94

【參考文獻】

相關(guān)期刊論文 前10條

1 鄭毅;;抽動障礙新觀念及診療進展[J];中國兒童保健雜志;2006年02期

2 艾紅梅,王昌富;腦脊液蛋白質(zhì)分析的臨床意義[J];國外醫(yī)學(xué)(臨床生物化學(xué)與檢驗學(xué)分冊);2004年04期

3 葛益謀;急性腦血管疾病血清S100B蛋白、NSE水平變化及其臨床意義[J];廣西醫(yī)科大學(xué)學(xué)報;2002年05期

4 肖光華;吳敏;;抽動障礙患者血清單胺類神經(jīng)遞質(zhì)的變化及意義[J];神經(jīng)疾病與精神衛(wèi)生;2008年05期

5 全守東;;223例抽動障礙兒童鐵鋅鉛含量分析[J];航空航天醫(yī)學(xué)雜志;2013年03期

6 胡家勝;劉智勝;;阿立哌唑在Tourette綜合征治療中的應(yīng)用前景[J];實用兒科臨床雜志;2011年06期

7 陳江魚;趙宏伊;李杰;謝成綱;席亞明;;兒童抽動障礙與病原微生物感染及其免疫的相關(guān)性[J];實用兒科臨床雜志;2012年19期

8 徐莉;袁傳順;陳新躍;杜娟;張子前;周亞紅;祁康泰;;熱性驚厥患兒血清鈉、鈣與神經(jīng)元特異性烯醇化酶聯(lián)合檢測的臨床意義[J];實用臨床醫(yī)藥雜志;2010年11期

9 蘇永棉;;血清MBP、S100B的變化在新生兒窒息中的臨床意義[J];中國當代醫(yī)藥;2012年10期

10 文霞,呂冰清,金麗娟;抽動-穢語綜合征單胺類神經(jīng)遞質(zhì)與AEEG、SPECT的研究[J];中華神經(jīng)科雜志;1998年03期

，

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