354例多发性抽动症患儿临床特点与诱因分析

Clinical characteristics and precipitating factor analysis of 354 children with Tourette syndrome

目的回顾性分析多发性抽动症(TS)患儿病例资料,为临床诊断提供参考。方法选取2016年6月至2021年2月深圳市中医院儿科门诊354例确诊TS患儿病例资料,分析患儿一般资料、临床资料与诱发因素。结果纳入的354例TS患儿中,男266例,女88例,男女比例为3.02∶1,学龄期儿童为主,发病年龄高峰6岁左右,4~12岁占91.81%;不同年龄层次性别比较,差异无统计学意义(P>0.05)。运动性抽动以眨眼最为多见,占比高达86.16%,其次分别摇头耸肩57.06%、张口咧嘴42.09%、抽鼻39.83%、扭肩甩头31.64%和腹肌抽动3.39%;而发声性抽动常表现为喉中异声,发生率为61.02%;各症状和性别之间比较,差异无统计学意义(P>0.05)。251例TS患儿发病与诱发因素有关,包括电子产品(49.00%)、学习压力(25.90%)、劳累(9.16%)、斥责打骂(7.97%)、外感因素(5.18%)、惊吓(2.39%)和外伤(0.40%)。结论TS是一组综合征,关注临床抽动症状是诊断的重点,本研究回顾性分析TS患儿病例资料,对早期诊断TS有帮助。

Objective To retrospectively analyze the case data of children with Tour ette syndrome(TS),so as to provide reference for clinical diagnosis.Methods A total of 354 children visiting the pediatric clinic of Shenzhen Traditional Chinese Medicine Hospital from June 2016 to February 2021 and diagnosed as TS were selected,and their general data,clinical data and precipitatin g factors were analyz ed.Results Among the 354 children with TS included,there were 266 males and 88 females,with a male to female ratio of 3.02∶1.Most of them were school-age children.The peak age for onset of TS was about 6 years old,and the age of 4-12 years old accounted for 91.81%.There were no statistically significant differences between different ages and genders(P>0.05).Eye blinking was the most common form of motor tics,accounting for 86.16%,which was followed by head jerking and shoulder shrugging,accounting for 57.06%,opening mouth and grinning,accounting for 42.09%,nos e twitching,accounting for accounting for 39.83%,s houlder twisting and head bobbing,accounting for 31.64%,and abdominal muscle twitching,accounting for 3.39%respectively.Vocal tics often manifested as inarticulate sounds produced in the throat,with an incidence of 61.02%.There were no statistically significant differences between varying symptoms and genders(P>0.05).The onset of TS f or 251 chil dren was rel ated to precipitating factors,including electronic products(49.00%),learning pressure(25.90%),fatigue(9.16%),scolding(7.97%),exogenous factors(5.18%),shock(2.39%)and trauma(0.40%).Conclusion TS is a comprehensive group of 9 syndromes.Paying attention to clinical tic symptoms is the focus of diagnosis.This study retrospectively analyzes the case data of children with TS,which is helpful for the early diagnosis of TS.