注意力缺陷多动障碍患儿血清低氧诱导因子1α的表达及其与呼吸功能的关系研究

Expression of hypoxia-inducible factor-1 α in children with attention deficit hyperactivity disorder and its relationship with respiratory function

目的 分析注意力缺陷多动障碍（ADHD）患儿血清低氧诱导因子1α（HIF-1α）的表达及其与呼吸功能的关系.方法 选择60例符合《美国精神障碍诊断与统计手册》第4版（DSM-Ⅳ）诊断标准的儿童注意力缺陷多动障碍为研究对象,设为ADHD组,按1：1入组60例健康儿童作为对照组,所有入组对象均采用酶联免疫法测定受试儿童血清中HIF-1α蛋白含量,采用生物反馈仪测定呼吸频率、呼吸幅度,采用峰速仪测定最大呼气峰流速值（PEF）,比较不同ADHD组与对照组HIF-1α水平及呼吸功能的差异,分析年龄、性别对HIF-1α水平及呼吸功能的影响.结果 ADHD组、对照组血清HIF-1α分别为（43.22±11.68） ng/L、（21.48±12.70） ng/L,呼吸频率分别为（17.47±2.82）次/min、（15.28±2.35）次/min,ADHD组HIF-1α、呼吸频率明显高于对照组（t=9.003、4.363,均P＜0.05）;ADHD组、对照组呼吸幅度分别为（2.36±1.18）cm、（3.03±1.05）cm,PEF分别为（191.42±30.06） L/min、（206.62±33.35） L/min,ADHD组呼吸幅度、PEF明显低于对照组（t=4.007、8.534,均P＜0.05）.ADHD组男童与女童HIF-1α水平、呼吸频率、呼吸幅度、PEF差异均无统计学意义（均P＞0.05）.ADHD组不同年龄HIF-1α水平、呼吸频率、呼吸幅度、PEF差异均无统计学意义（均P＞0.05）.ADHD组儿童HIF-1d与PEF之间呈负相关（r=0.422,P＜0.05）.结论 儿童ADHD与HIF-1α的表达异常、肺功能存在相关性,ADHD患儿肺容量减小,可造成脑轻度供氧不足,致使HIF-1α表达增加.

Objective To study the expression of hypoxia-inducible factor-1 α （HIF-1 α） in children with attention deficit hyperactivity disorder（ADHD）,and its relationship with respiratory function.Methods Sixty children with ADHD confirmed by DSM-IV were admitted as ADHD group.60 healthy children were selected as the normal control group.The serum level of HIF-1α was determined by enzyme-linked immunosorbent assay（ELISA）.Respiratory rate and respiratory amplitude were measured by biofeedback instrument.The PEF was measured by peak speed meter.The differences of HIF-1 α level and respiratory function between different ADHD groups and control group were analyzed.The influence of age and sex on HIF-1 α level and respiratory function was analyzed.Results The serum levels of HIF-1 α in ADHD group and healthy control group were （43.22-± 11.68） ng/L and （21.48 ± 12.70）ng/L respectively,the respiration rates were （17.47 ±-2.82）/min and （15.28 ± 2.35）/min respectively.The HIF-1 α and respiration rate of ADHD group were higher than healthy control group （t =9.003,4.363,all P 〈 0.05）.The respiratory amplitude in ADHD group and healthy control group were （2.36 ± 1.18） cm and （3.03 ± 1.05）cm respectively,the PEF in the two groups were （191.42 ± 30.06） L/min and （206.62 ± 33.35） L/min respectively.The respiratory amplitude and PEF of ADHD group were lower than healthy control group （t =4.007,8.534,all P 〈0.05）.There were no significant differences in HIF-1α level,respiratory rate,respiratory amplitude and PEF between boys and girls with ADHD （P 〉 0.05）.There were no significant differences in HIF-1 α level,respiratory rate,respiration amplitude and PEF between different age in ADHD children （P 〉 0.05）.There was a negative correlation between HIF-1 α and PEF in children with ADHD （r =0.422,P 〈 0.05）.Conclusion HIF-1 α and lung function are correlated with ADHD,ADHD children have small lung capacity,which may result in the hypoxia of the brain and the increase of HIF-1 α expression.