Tourette综合征患儿血清催乳素水平及神经心理功能的对照研究

Study of serum prolactin and neuropsychological function in tourette syndrome

目的 通过检测Tourette综合征 (TS)患儿血清催乳素 (PRL)水平及神经心理功能的变化 ,探讨TS的发病机制 ,并为诊断和治疗提供参考。方法 采用放射免疫分析法 (RIA)测定TS患儿及正常对照组儿童血清PRL水平。采用中国修订韦氏儿童智力量表 (WISC CR)、中国学龄前儿童气质量表 (CPTS)及中国学龄儿童气质量表 (CSTS)测查TS患儿神经心理特征。结果 未用药TS患儿血清PRL水平较对照组明显降低 (P <0 .0 0 1 ) ,经神经阻滞剂治疗后PRL水平较未用药组明显升高 (P <0 .0 0 1 )。TS患儿总智商 (FIQ)、言语智商 (VIQ)和操作智商 (PIQ)与对照组比较差异无显著性 (P >0 .0 5) ,但背数、译码和积木图案分测验分明显低于对照组 (P <0 .0 5)。TS患儿气质类型与常模组比较有高度显著性差异 (P <0 .0 0 1 )。结论 TS患儿存在中枢多巴胺(DA)系统过度活跃现象 ,外周血PRL水平可作为衡量中枢DA系统功能的良好指标 ,对指导诊断及治疗可能有一定参考意义。TS患儿存有认知功能的某些改变 ,这种改变可能是TS的一种伴随现象。TS患儿的气质特征有其独特性 。

Objective To study the level of serum prolactin(PRL) and neuropsychological changes in children with Tourette syndrome(TS)in order to explore the pathogenesis and direct the diagnosis and treatment of TS. Methods The serum prolactin levels of all subjects were measured by Radioimmunity Analysis. 58 untreated children and 15 normal children were tested by Wechsler Intelligence Scale for Children Chinese Revised. All children with TS were assessed with Chinese Preschool Children Temperament Scale and Chinese School Children Temperament Scale. Results The PRL level of untreated group significantly decreased as compared with that of normal group(P<0.001).The PRL level of treated group(P<0.001)was significantly higher than that of untreated group.The full intelligence quotient(FIQ),verbal intelligence quotient (VIQ)and performance intelligence quotient (PIQ) in TS group showed no significant difference as compared with control group(P>0.05).The digit span,symbol search and block design subtest scores in TS group were significantly lower than those in control group(P<0.001),respectively.The distribution of temperament type of TS group was significantly different from that of norm group(P<0.001). Conclusions The hyperactivity of dopamine in the central nervous system may exist in children with TS. Serum prolactin level may be used as a useful marker in reflecting DA activity and directing the diagnosis and treatment of TS. There were some deficits in the cognitive function of children with TS.The temperament trait of TS was distinct,which showed the genetic substrate of TS.