【摘要】：目的探討腫瘤壞死因子α過度表達(dá)在痙攣型腦性癱瘓發(fā)病中的臨床意義。 方法選擇小齡和大齡痙攣型腦性癱瘓各27例作為觀察組，同時(shí)設(shè)立小齡和大齡正常兒童對(duì)照組各14例。所有兒童均抽取外周靜脈血3ml，并對(duì)觀察組兒童進(jìn)行粗大運(yùn)動(dòng)功能分級(jí)系統(tǒng)（GMFCS）評(píng)估及生活活動(dòng)能力(ADL)評(píng)估，經(jīng)綜合康復(fù)治療6個(gè)月后重新進(jìn)行ADL評(píng)估一次。采用ELISA法檢測(cè)血清TNF-α水平，后將不同年齡組腦癱兒童及正常兒童的TNF-α水平進(jìn)行比較，并將腦癱兒童的TNF-α水平與其GMFCS級(jí)別及ADL改善程度進(jìn)行相關(guān)性分析，使用SPSS13.0統(tǒng)計(jì)軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。 結(jié)果觀察組的小齡及大齡痙攣型腦癱兒童血清TNF-α均較相應(yīng)年齡組對(duì)照組升高，差異均有統(tǒng)計(jì)學(xué)意義(P＜0.01)；觀察組內(nèi)小齡痙攣型腦癱兒童血清TNF-α較大齡痙攣型腦癱兒童血清TNF-α水平升高，且差異有統(tǒng)計(jì)學(xué)意義(P＜0.01)，，而對(duì)照組內(nèi)正常兒童的不同年齡段的血清TNF-α基本無差異；觀察組即痙攣型腦性癱瘓患兒血清TNF-α水平較正常兒童增高，且差異有統(tǒng)計(jì)學(xué)意義(P＜0.01)；痙攣型腦性癱瘓患兒血清TNF-α水平與其功能障礙程度相關(guān)性不顯著，但痙攣型雙癱及多癱兒童的血清TNF-α水平與其功能障礙程度有明顯相關(guān)性。同時(shí)痙攣型腦性癱瘓患兒血清TNF-α與其6個(gè)月康復(fù)訓(xùn)練后ADL改善程度明顯相關(guān)。 結(jié)論TNF-α在痙攣型腦性癱瘓患兒體內(nèi)持續(xù)過度表達(dá)，參與腦性癱瘓的后續(xù)腦損傷；痙攣型雙癱及多癱患兒的血清TNF-α水平與其功能障礙程度有明顯相關(guān)性；痙攣型腦性癱瘓患兒血清TNF-α水平與其6個(gè)月康復(fù)訓(xùn)練后ADL改善程度明顯相關(guān)，血清TNF-α可能成為評(píng)估痙攣型腦性癱瘓嚴(yán)重程度的指標(biāo)之一。
[Abstract]:Objective to investigate the clinical significance of tumor necrosis factor 偽 overexpression in spastic cerebral palsy. Methods 27 cases of spastic cerebral palsy of young age and 27 cases of old spastic cerebral palsy were selected as observation group, and 14 cases of young age and 14 cases of old normal children in control group were set up at the same time. The peripheral venous blood was extracted from all the children at 3 ml. The patients in the observation group were evaluated with (GMFCS) and (ADL) of gross motor function grading system. After 6 months of comprehensive rehabilitation treatment, the ADL was re-evaluated. Serum TNF- 偽 levels were measured by ELISA method. The TNF- 偽 levels in children with cerebral palsy and normal children of different age groups were compared, and the correlation between TNF- 偽 level and GMFCS grade and the improvement of ADL were analyzed. Use the SPSS13.0 statistical software to carry on the statistical analysis to the data. Results the serum TNF- 偽 of the young and older children with spastic cerebral palsy in the observation group was significantly higher than that in the control group (P < 0. 01). The level of serum TNF- 偽 in children with spastic cerebral palsy was significantly higher than that in control group (P < 0. 01), but there was no significant difference in serum TNF- 偽 between normal children and normal children in control group (P < 0. 01). The levels of serum TNF- 偽 in patients with spastic cerebral palsy were significantly higher than those in normal children (P < 0. 01), and there was no significant correlation between the level of serum TNF- 偽 and the degree of dysfunction in children with spastic cerebral palsy. However, the level of serum TNF- 偽 in children with spastic diplegia and polyplegia was significantly correlated with the degree of dysfunction. At the same time, serum TNF- 偽 was significantly correlated with the improvement of ADL after 6 months rehabilitation training in children with spastic cerebral palsy. Conclusion TNF- 偽 is continuously overexpressed in children with spastic cerebral palsy, which is involved in the subsequent cerebral injury of cerebral palsy, and the level of serum TNF- 偽 in children with spastic diplegia and polyplegia is significantly correlated with the degree of dysfunction. The level of serum TNF- 偽 in children with spastic cerebral palsy was significantly correlated with the improvement of ADL after 6 months rehabilitation training. Serum TNF- 偽 might be one of the indexes to evaluate the severity of spastic cerebral palsy.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R742.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 段軍;芮芳;唐久來;吳德;楊李;倪坤;魏薇;;腦性癱瘓兒童臨床分型與合并癥的相關(guān)性分析[J];安徽醫(yī)學(xué);2011年01期

2 吳華超;吳耀初;陳珊紅;陳俏倩;符有文;;小兒腦性癱瘓的CT和MR診斷[J];中國(guó)CT和MRI雜志;2012年05期

3 薛靜;陳立章;薛蕾;周權(quán);;小兒腦性癱瘓母親妊娠期危險(xiǎn)因素的Meta分析[J];中國(guó)當(dāng)代兒科雜志;2013年07期

4 李湘云;宋宗先;栗艷芳;;小兒腦性癱瘓臨床特征分析[J];中國(guó)實(shí)用神經(jīng)疾病雜志;2012年04期

5 張?zhí)m亭;萬明智;彭義成;萬貽欽;吳洪亮;凌小鵬;;小兒腦性癱瘓分型的商榷[J];中國(guó)臨床康復(fù);2006年42期

6 毛英麗;賈飛勇;胡曉蘭;秦麗霞;梁東;;腦性癱瘓的早期診斷及治療[J];中國(guó)婦幼保健;2009年09期

7 陳秀潔;李樹春;;小兒腦性癱瘓的定義、分型和診斷條件[J];中華物理醫(yī)學(xué)與康復(fù)雜志;2007年05期

8 陸晴友;腦癱的病因?qū)W研究[J];中國(guó)康復(fù)理論與實(shí)踐;2003年03期

9 孫楊;文芳;姚漢云;郭焱;肖玲;程自立;萬均成;;免疫炎性因子過度表達(dá)在腦性癱瘓發(fā)病機(jī)制中的作用[J];中國(guó)康復(fù)理論與實(shí)踐;2006年02期

10 史惟;楊紅;施炳培;王藝;王素娟;;國(guó)內(nèi)外腦性癱瘓定義、臨床分型及功能分級(jí)新進(jìn)展[J];中國(guó)康復(fù)理論與實(shí)踐;2009年09期

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