儿童孤独症的血浆谷氨酸和γ-氨基丁酸水平及其与伴发癫痫的关系

A study on plasma levels of glutamate and gamma-aminobutyric acid in childhood autism and their relationship with high comorbidity of epilepsy in autism.

目的探讨血浆谷氨酸(Glu)和γ-氨基丁酸(GABA)水平异常与儿童孤独症的关系,及其在儿童孤独症易发癫痫病理机制中的作用。方法从已经收集血样的儿童孤独症患者库(278例)中随机选择34例为总的患者组,其中不伴癫痫者30例(不伴癫痫组),伴癫痫者4例;而此库中所有伴发癫痫的27例患者为伴癫痫组,正常儿童36名为对照组。采用高效液相色谱法测定血浆Glu和GABA水平并进行上述3组间的比较。结果孤独症患者伴发癫痫的比例为9.7%(27/278)。总患者组的血浆Glu和GABA水平与对照组的差异均无统计学意义(t=1.09,P=0.28;t=0.56,P=0.58)。两两比较:伴癫痫组血浆Glu水平显著高于不伴癫痫组和对照组(H=8.93,P=0.003;H=10.65,P=0.001),而后两组间的差异无统计学意义(H=0.00,P=1.00);此3组间血浆GABA水平差异无统计学意义(H=5.38,P=0.07,df=2)。Pearson相关分析显示,患者组的血浆Glu及GABA水平分别与性别、年龄、病程、孤独症行为评定量表(Autism Behavior Checklist,ABC)评分等的相关均无统计学意义(P>0.05)。结论仅在伴发癫痫的孤独症儿童中发现血浆Glu水平的异常增高,这可能是孤独症易发癫痫的病理机制之一。

Objective To explore whether plasma levels of glutamate （Glu） and gamma-aminobutyric acid （ GA- BA） were related with autism, as well as the relationship between abnormality of Glu/GABA and the high comorbidity of epilepsy in autism. Methods Autism group consisted of 34 samples with a subgroup of 30 samples without epilepsy selected randomly from 278 autistic children. Autism with epilepsy group consisted of all 27 samples from 278 autistic children. Control group consisted of 36 well-matched healthy children. High performance liquid chromatography was used to measure plasma levels of Glu and GABA. Multiple comparisiou was performed among autism group without epilepsy, autism group with epilepsy and control group. Results Rate of comorbidity of epilepsy in autism was 9. 7% （ 27/278 ）. There were no significant differences in plasma levels of Glu and GABA between autism group and control group （ t = 1.09, P = 0. 28 ; t = 0. 56, P = 0. 58）. Plasma level of Glu in autism with epilepsy group was significantly higher than autism without epilepsy group and control group （ H=8.93, P = 0. 003 ; H=10. 65, P = 0. 001 ）. No significant difference was found in plasma level of Glu between autism without epilepsy group and control group （ H =0.00, P = 1.00）. No significant difference was found in plasma level of GABA among the three groups （H = 5.38, P = 0. 07, df = 2）. Pearson correlation analysis suggested that plasma level of Glu and GABA were not correlated with gender, age, course of disease, score of Autism Behavior Checklist （ABC） respectively （ P 〉 0. 05 ）. Conclusions The abnormalities of plasma levels of Glu and GABA are not common in global autistic children. But autistic children with epilepsy has increased plasma level of Glu, which suggests that dysfunction of gluergic system may play a role in high comorbidity of epilepsy in autism.