Tourette综合征的临床特点及其多变量分析

Clinical characteristics and multivariable analysis or Tourettesyndrome

探讨Tourette综合征（TS）的临床特点和心理行为问题。方法采用TS问卷表和TS家庭状况调查表收集临床资料，并进行多变量相关分析。结果39例TS患儿起病年龄2．5a～11a，男女之比5．5：1。25．6％（10／39例）有抽动障碍家族史。53．8％（21／39例）表现有感觉性抽动。74．4％（29／39例）以头面部运动性抽动为首发症状，其中眨眼占46．1％（18／39例）。运动性抽动以眨眼、摇头和耸肩最常见；发声性抽动以吭吭声最常见。伴随的行为问题以多动、学习困难、夜惊、梦语和攻击行为等比较常见。66．7％（26／39例）TS患儿的父母采用打骂体罚管教方式。多变量相关分析发现TS患儿伴随的行为问题与打骂体罚管教方式呈显著正相关（r=0．3796，P＜0．05）。结论TS平均起病年龄6．5～7a，男孩多于女孩，存在遗传倾向。感觉性抽动属于先兆症状，眨眼是最常见的首发症状。伴有较多的行为问题。不良的环境因素对TS的发病有一定的影响。

Objective To investigate the clinical characteristics ofTourette syndrome (TS)and its psychological behavior problems.Methods The clinical data were collected by means of TSquestionnaire and TS family status questionnaire. The mlultivariableanalysis was carried out.Results Onset age of 39 cases with TS was 2. 5 to 11 years andthe ratio of boys and girls was 5. 5 us 1. Family history tie disorders was 25. 6 % (10/39). Sensory tics appeared in 53. 8% (21/39).Motor ties of head and face as first symptoms were 74. 4 % (29/39),in which eye blinking was 46. 1% (18/39). The most motor ties wereeye blinking,head shaking and shoulder shrugging. The most vocaltie was throat clearing. TS might be usually accompanied by morebehavior problems such as hyperactivity, learning difficulty, nightterrors, sleep-speaking, aggressive behavior and so on. Educationway of hitting-scolding was 66. 7 % (26/39). The multivariable correlative analysis showed that behavior problems of TS were significantly correlated with education way of hitting-scolding (r=0. 3796, P＜0. 05).Conclusion The average onset age of TS is 6. 5 to 7 years andboys with TS is more than girls. TS is possessed of hereditarytendency. Sensory ties are regarded as the premonitory symptoms andeye blinking is the most first symptoms of TS. TS might be usuallyaccompanied by more behavior problems and there might be the effeet of harmful environment factors on its pathogeny.