脑性瘫痪患儿血清肿瘤坏死因子-α水平与适应性发育商、粗大运动功能评估量表评分的相关性分析

Correlation analysis of serum TNF-α level and development quotient,GMFM-88 score in children with cerebral palsy

目的:探究脑性瘫痪患儿血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平与适应性发育商(development quotient,DQ)、粗大运动功能评估量表-88(GMFM-88)评分相关性及临床意义。方法:选取42例脑性瘫痪患儿作为病例组,同期选取45例正常儿童作为对照组。比较两组研究对象血清中TNF-α、IgA、IgG水平以及DQ与GMFM-88评分情况;分析病例组患儿血清TNF-α与DQ、GMFM-88评分间的相关性。结果:两组血清IgA及IgG水平比较无统计学差异(P>0.05),但病例组血清TNF-α水平显著高于对照组(t=14.57,P<0.001);病例组DQ与GMFM-88评分显著小于对照组(t=10.18,P<0.001)(t=14.11,P<0.001);病例组血清TNF-α与DQ(r=-0.478,P<0.001)及GMFM-88(r=-0.538,P<0.001)均呈负相关,DQ与GMFM-88(r=0.679,P<0.001)呈显著正相关。结论:脑瘫患儿血清TNF-α表达显著升高,且与DQ与GMFM-88评分均呈负相关,提示TNF-α水平上升伴有脑损伤加重,影响智力发育和粗大运动发育,同时粗大运动发育与智力发育具有同步性,临床应加强相关的早期干预治疗。

Objective： To discuss the correlation between serum tumor necrosis factor-α（ TNF-α） level and development quotient（ DQ）,GMFM-88 score and clinical significance in children with cerebral palsy. Methods： 42 children with cerebral palsy were selected as the patients group,and the normal children were selected as the control group in the same period. The levels of TNF-α,IgA and IgG in serum of two groups were compared,and the correlation between DQ and GMFM-88 score was analyzed. The correlation between serum TNF-α and DQ,GMFM-88 score in the observation group was analyzed. Results： No significant differences between serum IgA and IgG levels in the two groups（ P〉0. 05）,but the serum levels of TNF-α（ t = 14. 57,P〈0. 001） was significantly higher than the control group; DQ（ t = 10. 18,P〈0. 001） and GMFM-88（ t = 14. 11,P〈0. 001） the observation group was significantly lower than that of control group; serum TNF-α and DQ（ r =-0. 478,P〈0. 001）,GMFM-88（ r =-0. 538,P〈0. 001） were negatively related,DQ and GMFM-88（ r = 0. 679,P〈0. 001） showed a significant positive correlation. Conclusions： The expression of serum TNF-α in children with cerebral palsy alpha was significantly increased,and the DQ and GMFM-88 scores were negatively correlated,suggesting that TNF-α levels increase with brain damage,leading to influence the development of intelligence and gross motor,meanwhile the development of gross motor and intellectual were synchronous,early clinical related support should be strengthened.