抽动秽语综合征患儿与正常儿童适应行为比较(英文)

Comparison of the adaptive behaviors between normal children and children with Tourette syndrome

背景:抽动秽语综合征(tourettesyndrome,TS)患儿的学习和社会适应能力有一定障碍,对TS患者适应行为能力的评估,有助于弥补TS所致的功能缺损。目的:比较TS患儿与正常儿童的适应行为能力,寻找进行干预的可能性。设计:以患者和正常学生为研究对象,横断面的病例-对照,观察对比研究。单位:一所大学医院儿科。对象:1999-10/2001-10就诊于首都医科大学附属北京安定医院儿科门诊以及住院患儿33例(患儿组),纳入标准为符合ICD-10TS诊断标准的知情同意的患者。男17例,女16例。对照组为同期随机抽自北京市一普通小学2～5年级学生,共33名,男16名,女17名,无TS、注意缺陷多动障碍、品行问题和情绪问题,经老师和家长同意后加入研究。方法:采用儿童适应行为量表对33例TS患儿和33名正常儿童进行了评定。主要观察指标:儿童适应行为评定量表评分。结果:TS患儿除感觉运动(23.7±0.6)和时空定向项目(11.7±3.0)与正常儿童(23.6±0.7,12.8±3.2)接近外,其他分量表、因子和适应能力商数均低于正常儿童,差异有统计学显著意义(t=3.21～11.91,P<0.05～P<0.01),且与该病的严重程度呈负相关(r=-0.377～0.661,P<0.05～0.01)。结论:TS患儿的适应能力评估对TS的严重程度的判断有重要作用,对治疗措施的拟订有指导意义。

BACKGROUND:Children with Tourette syndrome(TS) have certain handicaps in learning and social adaptation.An appropriate assessment of the ability of adaptive behaviors of TS children will be helpful to repair the functional impairment caused by TS.OBJECTIVE:To compare the adaptive behaviors between TS children and normal children.DESIGN:A cross sectional case controlled observational comparative study,taking TS children and normal students as the subjects.SETTING:A pediatric department of a university hospital. PARTICIPANTS:The TS group enrolled 33 TS children(17 boys and 16 girls),including the inpatients and outpatients in the Department of Pediatrics,Beijing Anding Hospital of Capital University of Medical Sciences from October 1999 to October 2001.All of them voluntarily entered the study,and they met the diagnostic criteria of the ICD 10 TS.The control group included another 33 pupils(16 boys and 17 girls) .They were randomly selected from a common primary school in Beijing. They were in grade 2 to 5,had no disorders such as TS,attention deficit hyperactivity disorder,conductive problems,and emotional problems.Informed contents were obtained from their teachers and parents.INTERVENTIONS:Thirty three TS children and 33 normal children were assessed with the children adaptive behavior scales(CABS).MAIN OUTCOME MEASURES:Scores of CABS.RESULTS:The adaptive quotients and scores of most subscales in TS children were significantly lower than those in normal controls except the scores of sensorimotor[(23.7±0.6) vs(23.6±0.7)]and time space orientation[(11.7±3.00) vs(12.8±3.2)](t=3.21 to 11.91,P< 0.05 or P< 0.01),and the low scores were negatively correlated with the severity of TS(r=-0.377 to 0.661,P< 0.05 or P< 0.01).CONCLUSION:The assessment of adaptive behavior in TS children is an important approach to determine the severity of TS, and can also be used to guide therapy.