儿童抽动症相关因素的研究

Study on related factors of tourette syndrome

目的探讨儿童抽动症与新生儿高胆红素血症的关系。方法选取2010年3月至2014年2月宁波大学医学院附属医院儿科门诊收治的1002例儿童抽动症儿童作为病例组,随机抽取门诊体检的1208例健康儿童作为对照组。采用调查问卷调查两组资料,并检测血清总胆红素(TBC)、未结合胆红素(UCB)、白蛋白(ALB)、神经元特异性烯醇化酶(NSE)和血清S-100蛋白含量。结果病例组和对照组在家族抽动史、生理性黄疸史、病理性黄疸史、反复呼吸道感染史、分娩方式等方面存在显著性差异(X^2值分别为4.396、5.127、4.973、6.015、4.963,均P<0.05);两组TBC、UCB、胆红素与白蛋白的联接状态(B/A值)、NSE和S-100方面比较存在显著性差异(t值分别为6.159、7.894、6.755、2.311、2.325,均P<0.05)。家族抽动史、生理性黄疸史史、病理性黄疸史、反复呼吸道感染史、TBC、UCB、B/A值、NSE和S-100是儿童多发性抽动症的独立影响因素(OR=值分别为3.392、1.842、3.102、3.012、2.012、1.698、2.018、2.013、1.993,均P<0.05)。结论儿童多发性抽动症是受多种因素影响的疾病,其中新生儿高胆红素血症是儿童多发性抽动症的主要危险因素之一。

Objective To investigate the relationship between tourette syndrome （ TS ） of children and neonatal hyperbilirubinemia . Methods From March 2010 to February 2014 totally 1 002 children with TS admitted in Affiliated Hospital of Medical College of Ningbo University were recruited in case group .Another 1 208 cases undergoing health examination were randomly selected in control group .Data of two groups was collected by questionnaire survey .Serum total bilirubin （ TB ） , unconjugated bilirubin （ UCB ） , albumin （ ALB ） , neuron-specific enolase （ NSE） and serum S-100 protein were detected .Results There were significant differences between two groups in Tic family history, physiological jaundice history , history of jaundice, repeated respiratory infection and delivery mode （χ2 value was 4.396, 5.127, 4.973, 6.015 and 4.963, respectively, all P〈0.05）, and TB, UCB, B/A, NSE and S-100 were also significantly different between two groups （t value was 6.159, 7.894, 6.755, 2.311 and 2.325, respectively, all P〈0.01）.Tic family history, physiological jaundice history , history of jaundice , history of recurrent respiratory tract infections , TBC, UCB, B/A, NSE and S-100 were independent risk factors of TS （OR value was 3.392, 1.842, 3.102, 3.012, 2.012, 1.698, 2.018, 2.013 and 1.993, respectively, all P〈0.05）.Conclusion Children TS is a disease influenced by many factors , and neonatal hyperbilirubinemia is the major risk factor .