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目的探讨对立违抗性障碍(ODD)患儿的临床特征及血清单胺类神经递质水平的变化。方法对31例 ODD 儿童(研究组)和36名正常儿童(对照组)测评 Piers-Harris 儿童自我意识量表(PHCSS)、儿童焦虑性情绪障碍筛查表(SCRED)、儿童抑郁障碍自评量表(DSRSC)及儿童冲动量表(BIS),测量其血清5-羟色胺(5-HT)、多巴胺(DA)等生物胺神经递质的含量。结果(1)研究组PHCSS 中的合群性分[(7.36±1.81)分]、幸福与满足感分[(5.45±1.69)分]低于对照组[(8.56±2.50)分和(6.31±1.72)分;P=0.030,P=0.045]。(2)两组 SCRED 和 DSRSC 评分的差异无统计学意义(P>0.05)。研究组 BIS 的冲动总分[(51.81±9.97)分]、运动分[(8.77±4.11)分]高于对照组[(48.30±11.57)分和(5.19±2.46)分;P=0.020,P=0.000]。(3)研究组血清高香草酸水平[中位数(M)=59 nmol/L]、5-HT 水平(M=20 nmol/L)低于对照组(M=130 nmol/L 和168 nmol/L;P=0.024,P=0.033)。(4)血清5-HT 水平与冲动总分(r=-0.650)、注意因子分呈负相关(r=-0.688);血清 DA 水平与广泛焦虑因子呈正相关(r=0.591);血清5-羟吲哚乙酸水平与分离焦虑因子、社交恐怖因子均呈负相关(r=-0.593,r=-0.535);血清高香草酸水平与抑郁(r=-0.694)、冲动因子呈负相关(r=-0.608),均 P<0.05和 P<0.01。结论 ODD 儿童不合群,缺乏愉快感,冲动性高;其血清5-HT 水平降低,而血清儿茶酚胺水平变化不明显。
Objective To investigate the clinical features and serum monoamine neurotransmitter levels in children with Oppositional Disorder (ODD). Methods The Piers-Harris Children’s Self-Consciousness Scale (PHCSS), Children’s Anxiety Emotional Disorders Inventory (SCRED), Children’s Depression Disorder Self-Rating Scale (PADS), 31 children with ODD (study group) and 36 normal children (DSRSC) and Child Impulsiveness Scale (BIS) were used to measure the content of biogenic neurotransmitters such as serotonin (5-HT) and dopamine (DA). Results (1) The cohort score (7.36 ± 1.81) in the PHCSS group was significantly lower than that in the control group [(5.45 ± 1.69) points vs (8.56 ± 2.50) and (6.31 ± 1.72) points ) Points; P = 0.030, P = 0.045]. (2) There was no significant difference between the two groups in SCRED and DSRSC scores (P> 0.05). The impulsive total score [(51.81 ± 9.97) min] and exercise score [(8.77 ± 4.11) min] in the study group were significantly higher than those in the control group [(48.30 ± 11.57) and (5.19 ± 2.46) = 0.000]. (3) The serum vanillic acid level of the study group was lower than that of the control group (M = 130 nmol / L and 168 nmol [M = 59 nmol / L] /L;P=0.024,P=0.033). (4) Serum 5-HT levels were positively correlated with general anxiety factors (r = -0.650) and negative There was a negative correlation between the level of HIBH and the level of anxiety and social horror factors (r = -0.593, r = -0.535). The level of vanillin in serum was negatively correlated with depression (r = -0.694) and impulsivity = -0.608), both P <0.05 and P <0.01. Conclusions Children with ODD are out of group, lack of pleasure and impulsiveness. Their serum 5-HT level is decreased, while serum catecholamine level is not changed significantly.