孤独症谱系障碍患儿血清甘丙肽、神经丝轻链水平与病情严重程度的相关性研究

Correlation between serum galanin and neurofilament light chain levels and severity ofautism spectrum disorder in children

目的探讨孤独症谱系障碍(ASD)患儿血清甘丙肽(GAL)、神经丝轻链(NfL)水平与病情严重程度的相关性。方法选择2020年10月至2022年10月重庆市开州区人民医院收治的80例ASD患儿(ASD组)和62例健康儿童(对照组)为研究对象,根据儿童自闭症评估量表(CARS)评分将ASD患儿分为轻中度组(44例)和重度组(36例)。检测血清GAL、NfL水平,分析GAL、NfL与CARS参数的关系,受试者工作特征(ROC)曲线分析GAL、NfL诊断ASD的价值。结果ASD组血清GAL、NfL水平均高于对照组,差异有统计学意义(t值分别为29.926、25.029,P<0.05);重度组血清GAL、NfL水平均高于轻中度组,差异有统计学意义(t值分别为5.053、5.602,P<0.05);ASD患儿血清GAL、NfL水平与CARS参数人际关系、情感反应、对环境变化的适应、焦虑反应、语言交流、非语言交流、活动水平、CARS总分呈正相关性,差异有统计学意义(r值介于0.241~0.698之间,P<0.05);GAL、NfL诊断ASD的曲线下面积分别为0.736、0.796,联合诊断的曲线下面积为0.884,大于单独GAL和NfL的诊断效能(Z值分别为3.323、2.402,P<0.05)。结论ASD患儿血清GAL、NfL水平显著增高,且与病情严重程度有关,可作为ASD辅助诊断的生物学标志物。

Objective To investigate the correlation between serum galanin(GAL)and neurofilament light chain(NfL)levels and the disease severity in children with autism spectrum disorder(ASD).Methods A total of 80 children with ASD(ASD group)and 62 healthy children(control group)admitted to Kaizhou District People s Hospital in Chongqing from October 2020 to October 2022 were selected for the study.The ASD children were divided into mild-moderate group(44 cases)and severe group(36 cases)according to Childhood Autism Rating Scale(CARS)score.Serum GAL and NfL levels were detected to analyse the relationship between GAL and NfL and CARS parameters,and the value of GAL and NfL for the diagnosis of ASD was analysed by the subject s work characteristics(ROC)curve.Results The levels of serum GAL and NfL in ASD group were higher than those in control group,and the difference was statistically significant(t=29.926 and 25.029,respectively,P<0.05).The levels of serum GAL and NfL in severe group were higher than those in mild-moderate group,with statistical significance(t=5.053 and 5.602,respectively,P<0.05).The levels of serum GAL and NfL in children with ASD were positively correlated with the CARS parameters interpersonal relationship,emotional response,adaptation to environmental changes,anxiety response,verbal communication,non-verbal communication,activity level,and the total CARS score,and the difference was statistically significant(r=0.241-0.698,respectively,all P<0.05).The area under the curve(AUC)of GAL and NfL for the diagnosis of ASD was 0.736 and 0.796,respectively,and the AUC of the combined diagnosis was 0.884,which was greater than the diagnostic efficacy of GAL and NfL individually(Z=3.323 and 2.402,respectively,P<0.05).Conclusion The serum GAL and NfL levels are significantly higher in children with ASD and correlate with the disease severity,which can be used as biological markers for the secondary diagnosis of ASD.