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目的:观察托吡酯(TPM)对抽动-秽语综合征(TS)患儿血浆兴奋性氨基酸中谷氨酸(Glu)和门冬氨酸(Asp)含量的影响。方法:选择40例TS患儿(治疗组),予以TPM治疗至少12周。分别在治疗前及治疗12周后检测TS患儿血浆Glu和Asp的含量,并评估其治疗效果。选择我院体检正常儿童30例作对照(对照组)。结果:治疗组TS患儿治疗前血浆Glu和Asp含量较对照组明显增加(P<0.01)。应用TPM治疗12周后,患儿血浆Glu和Asp含量较治疗前明显下降(P<0.01);同时患儿耶鲁综合抽动严重度量表(YGTSS)评分指标运动性抽动分数、发声性抽动分数和综合损害分数均显著降低(P<0.01)。结论:兴奋性氨基酸可能参与TS的发病过程。TPM治疗TS患儿的临床疗效确切,能明显降低患儿YGTSS评分,作用机制可能通过降低血浆兴奋性氨基酸的含量。
Objective: To investigate the effect of topiramate (TPM) on glutamate (Glu) and aspartate (Asp) contents in plasma excitatory amino acids in children with Tourette’s syndrome (TS). Methods: Forty infants with TS (treatment group) were selected and treated with TPM for at least 12 weeks. The plasma levels of Glu and Asp in children with TS were measured before treatment and after 12 weeks of treatment, respectively, and the therapeutic effect was evaluated. Select 30 cases of normal children in our hospital as a control (control group). Results: The levels of plasma Glu and Asp in treatment group before treatment were significantly higher than those in control group (P <0.01). The levels of plasma Glu and Asp in children with TPM were significantly lower than those before treatment (P <0.01) after 12 weeks of TPM treatment. At the same time, the scores of YTTS, tachycardia and vocal tic scores The damage scores were significantly lower (P <0.01). Conclusion: Excitatory amino acids may be involved in the pathogenesis of TS. The clinical efficacy of TPM in the treatment of children with TS is exact, can significantly reduce the YGTSS score in children, the mechanism may be by reducing the content of plasma excitatory amino acids.