發(fā)布時(shí)間：2019-05-24 11:35

【摘要】：目的探討兒茶酚-O-甲基轉(zhuǎn)移酶(catechol-O-Methyltransferase,COMT)基因多態(tài)性對(duì)注意缺陷多動(dòng)障礙(attention deficit hyperactivity disorder,ADHD)兒童服用哌甲酯治療效果的影響。方法對(duì)177例漢族ADHD患兒進(jìn)行2~4周的哌甲酯開(kāi)放劑量滴定,獲得最佳治療反應(yīng)。在治療前后使用ADHD診斷量表(父母版)對(duì)患兒行為變化進(jìn)行定量評(píng)估,并將療效分為緩解、有效和無(wú)效。檢測(cè)COMT基因rs4680(Val158Met)和rs165599多態(tài)性,比較不同基因型患兒的療效。結(jié)果 rs4680不同基因型患兒治療效果的差異有統(tǒng)計(jì)學(xué)意義(P0.01):G/G型緩解38例(40.9%),有效19例(20.4%),無(wú)效36例(38.7%);G/A型緩解35例(48.6%),有效16例(22.2%),無(wú)效21例(29.2%);而A/A型緩解僅1例(100%),有效0例,無(wú)效9例(90.0%)。不同基因型患兒ADHD診斷量表總分、注意缺陷分和多動(dòng)沖動(dòng)分治療前后變化值的差異有統(tǒng)計(jì)學(xué)意義(P0.05),G/-型比A/A型量表得分的變化更大(P0.05)。而rs165599不同基因型患兒療效差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 COMT基因rs4680(Val158Met)多態(tài)性與哌甲酯治療反應(yīng)存在關(guān)聯(lián),rs4680的G等位基因攜帶者治療反應(yīng)優(yōu)于A/A基因型者。
[Abstract]:Objective to investigate the effect of catechol-O-methyltransferase (catechol-O-Methyltransferase,COMT) gene polymorphism on the efficacy of methyl piperate in children with attention deficit hyperactivity disorder (attention deficit hyperactivity disorder,ADHD). Methods 177 children with ADHD of Han nationality were treated with open dose titration of methyl piperate for 2 weeks and 4 weeks to obtain the best therapeutic response. Before and after treatment, ADHD diagnostic scale (parental version) was used to quantitatively evaluate the behavioral changes of children, and the curative effect was divided into remission, effective and ineffective. Rs4680 (Val158Met) and rs165599 polymorphism of COMT gene were detected to compare the efficacy of different genotypic children. Results there were significant differences in the therapeutic effect of different rs4680 genotypic children (P 0.01): 38 cases (40.9%) were relieved by G / G type, 19 cases (20.4%) were effective and 36 cases (38.7%) were ineffective. 35 cases (48.6%) were relieved, 16 cases (22.2%) were effective and 21 cases (29.2%) were ineffective, while only 1 case (100%) was effective, 0 cases were effective and 9 cases (90.0%) were ineffective. There were significant differences in the total score of ADHD diagnostic scale, attention deficit score and hyperactivity impulse score before and after treatment (P 0.05). The score of G / A scale changed more significantly than that of A / A scale (P 0.05). However, there was no significant difference in curative effect among children with different rs165599 genotypes (P 0.05). Conclusion the rs4680 (Val158Met) polymorphism of COMT gene is associated with the therapeutic response of methyl piperate. The therapeutic response of G allele carriers of rs4680 is better than that of A 鈮，

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