注射用鼠神经生长因子联合重复经颅磁刺激对自闭症患儿金属硫蛋白-2A金属硫蛋白3水平的影响

Effect of mouse nerve growth factor for injection combined with repeated transcranial magnetic stimulation on metallothionein-2A and MT3 protein levels in children with autism

目的探讨对自闭症患儿通过注射用鼠神经生长因子与重复经颅磁刺激联合对金属硫蛋白-2A、金属硫蛋白3(MT3蛋白)水平的影响。方法采集106例台州市第一人民医院2019年3月—2021年3月诊治的自闭症患儿为研究对象,分为对照组、观察组各53例。对照组通过重复经颅磁刺激治疗,观察组给予注射用鼠神经生长因子与重复经颅磁刺激联合治疗。检测两组的金属硫蛋白-2A、MT3蛋白、脑源性神经营养因子(BDNF)、血清指标谷氨酸(Glu)、微量元素锌、铜、维生素D及维生素E水平,通过孤独症行为量表(ABC)和儿童孤独症评定量表(GARS)对临床疗效进行评估,统计两组头疼、恶心及嗜睡出现情况。结果治疗后观察组MT3蛋白(925.78±92.78 vs.811.98±80.98)ng/L、BDNF(172.34±17.56 vs.150.93±15.74)μg/L、微量元素锌(14.50±1.40 vs.12.02±1.21)μmol/L、维生素D(62.78±6.78 vs.56.89±5.69)nmol/L、维生素E(11.78±1.80 vs.9.14±0.91)μg/ml水平高于对照组(P<0.05),金属硫蛋白-2A(711.15±70.22 vs.800.12±80.25)ng/ul、Glu(15.47±1.48 vs.19.78±1.98)mmol/L、微量元素铜(16.24±1.67 vs.20.15±2.15)μmol/L水平、ABC评分(36.50±3.40 vs.42.02±3.21)分、GARS评分(30.24±3.07 vs.33.15±3.15)分低于对照组(P<0.05)。观察组治疗有效率高于对照组94.34 vs.69.81)%,差异有统计学意义(P<0.05),观察组治疗不良反应发生率略高于对照组(5.66 vs.3.77)%,差异无统计学意义(P>0.05)。结论注射用鼠神经生长因子与重复经颅磁刺激联合治疗可提高自闭症患儿MT3蛋白水平,金属硫蛋白-2A水平下降,微量元素、维生素异常及临床症状改善。

Objective To explore the effect of combined injection of mouse nerve growth factor and repeated transcranial magnetic stimulation on the levels of metallothionein-2A and metallothionein 3(MT3 protein)in children with autism.Methods A total of 106 chil⁃dren with autism who were diagnosed and treated in our hospital from March 2019 to March 2021 were collected as the research objects,and were divided into a control group and an observation group with 53 cases each.The control group was treated with repeated transcranial mag⁃netic stimulation,and the observation group was given combined treatment with injection of mouse nerve growth factor and repeated transcra⁃nial magnetic stimulation.Detect the levels of metallothionein-2A,MT3 protein,brain-derived neurotrophic factor(BDNF),serum index glutamate(Glu),trace elements zinc,copper,vitamin D,and vitamin E in the two groups,and measure through autistic behavior Table(ABC)and Child Autism Rating Scale(GARS)were used to evaluate the clinical efficacy,and count the occurrence of headache,nausea,and lethargy in the two groups.Results After treatment,MT3 protein(925.78±92.78 vs.811.98±80.98)ng/L,BDNF(172.34±17.56 vs.150.93±15.74)ug/L,trace element zinc(14.50±1.40 vs.12.02±1.21)μmol/L and vitamin were observed in the observation group The levels of D(62.78±6.78 vs.56.89±5.69)nmol/L and vitamin E(11.78±1.80 vs.9.14±0.91)ug/ml were higher than those of control group(P<0.05).Metallothionein-2a(711.15±70.22 vs.800.12±80.25)ng/ul,Glu(15.47±1.48 vs.19.78±1.98)mmol/L,trace element copper(16.24±1.67 vs.20.15±2.15)μmol/L,ABC score The scores of(36.50±3.40 vs.42.02±3.21)and GARS(30.24±3.07 vs.33.15±3.15)were lower than those of the control group(P<0.05).The effective rate of treatment in the observation group was higher than that in the control group(94.34 vs.69.81)%,the difference is statistically significant(P<0.05),and the inci⁃dence of adverse reactions in the observation group was slightly higher than that in the control group(5.66 vs.3.77)%,the difference was not statistically significant(P>0.05).Conclusion The combined treatment of mouse nerve growth factor for injection and repeated tran⁃scranial magnetic stimulation can increase the level of MT3 protein in children with autism,decrease the level of metallothionein-2A,abnor⁃mal trace elements and vitamins,and improve clinical symptoms.