耶鲁抽动症整体严重度量表对抽动障碍患儿的临床评估

The introduction of Yale Globle Tic Severity Scale into the clinical evaluation of children with tic disorders

目的引进耶鲁抽动症整体严重度量表(YGTSS)并评估其与临床症状轻重的关系,以及以量表积分在观察者间的一致性。方法2001年7月至2002年6月成都市儿童医院全文翻译YGTSS,未予修改,观察72例抽动患儿YGTSS总积分与临床抽动症状严重度分型的关系和该量表积分进步率与治疗后症状改善程度的关系(临床效度检验),观察24例患儿该量表运动和发声抽动数量、频度、强度、复杂性、干扰性5个维度积分及总积分在观察者间一致性。结果抽动患儿该量表总积分与临床抽动症状严重度分型之间和该量表积分进步率与治疗后症状改善程度之间有较好的效度(F值分别为59·31和124·44,P均<0·01),运动和发声抽动数量、频度、强度、复杂性、干扰性5个维度积分及总积分的组内相关系数(ICC)值均大于0·7,显示较好的观察者间一致性。结论耶鲁抽动症整体严重度量表中译本具有较好的信度和效度,是衡量抽动症状严重程度的工具之一。

Objective To introduce Yale Globle Tic Severity Scale（ YGTSS ） and evaluate its efficacy and reliability. Methods The scale was translated into Chinese with the effort to keep its original literal meaning. From July 2001 to June 2002,72 cases of tic children were evaluated with YGTSS：their total scores were compared with disease severity refleeted by their ICD-10 classification;the clinical efficacy was also evaluated through comparing their score increment after treatment and the subjective judgement on the clinical improvement by the patents. In Another 24 patients ,5 dimensional scores （ number, frequency, intensity, complexity and interference） of both movement and vocal tics were recorded. Together with their total scores, the inter-observer reliability of the scale was evaluated. Results The total scores of tic children were found to be consistent with the ICD-10 Classification and the score increment correlated well with the clinical improvement（ F =59. 31 and 124. 44,respectively, P 〈0. 01 ）. The intraclass correlation coefficient（ ICC ） of 5 dimensional scores of movement and vocal tics as well as the total scores were all greater than 0. 7, indicating the excellent interobserver consistency of the scale. Conclusion The Chinese version of YGTSS shows good efficiency and reliability, hence should be a useful method in evaluating tic severity.