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目的:探讨注意缺陷多动障碍(ADHD)儿童体内IL-1β、IL-6、TNF-α含量变化及可能的发病机制;分析IL-1β、IL-6、TNF-α与ADHD症状特征及行为问题的关系。方法:对35例符合DSM-Ⅳ诊断标准的ADHD和25例正常儿童进行血清IL-1β、IL-6、TNF-α浓度测定,选用Achenbach儿童行为量表(CBCL)进行行为评定,比较两组IL-1β、IL-6、TNF-α浓度水平,并与DSM-Ⅳ诊断标准和CBCL得分进行相关分析。结果:ADHD儿童IL-1β较对照组增高,差异有统计学意义(χ2=4.239,P=0.041;Z=2.051,P=0.040);IL-6较对照组增高,但差异不具统计学意义(χ2=3.138,P=0.074;Z=1.892,P=0.058);TNF-α较对照组降低,差异有统计学意义(χ2=5.173,P=0.023;Z=2.792,P=0.005);TNF-α与注意缺陷因子、多动/冲动因子负相关(r=-0.377,P=0.003;r=-0.274,P=0.034);IL-1β与注意缺陷因子正相关(r=0.273,P=0.035);TNF-α与CBCL注意问题、违纪行为、攻击行为、外向性、行为问题总分负相关(r=-0.325,P=0.011;r=-0.396,P=0.002;r=-0.306,P=0.017;r=-0.324,P=0.011;r=-0.346,P=0.007)。结论:ADHD儿童存在高水平的IL-1β和低水平的TNF-α;IL-1β尤其是TNF-α与ADHD注意缺陷症状及某些行为问题间存在关联性。
Objective: To investigate the changes and possible pathogenesis of IL-1β, IL-6 and TNF-α in children with Attention Deficit Hyperactivity Disorder (ADHD). To analyze the characteristics and behaviors of IL-1β, IL-6, TNF- The relationship between problems. Methods: Serum levels of IL-1β, IL-6 and TNF-α were measured in 35 ADHD children and 25 normal children with DSM-Ⅳ diagnostic criteria. Achenbach Children’s Behavior Scale (CBCL) was used for behavioral assessment. IL-1β, IL-6 and TNF-α, and correlated with DSM-Ⅳ diagnostic criteria and CBCL score. Results: The level of IL-1β in children with ADHD was significantly higher than that in control group (χ2 = 4.239, P = 0.041; Z = 2.051, P = 0.040) (χ2 = 3.138, P = 0.074; Z = 1.892, P = 0.058); TNF-α was lower than that of the control group, the difference was statistically significant (χ2 = 5.173, (r = -0.377, P = 0.003; r = -0.274, P = 0.034). IL-1β was positively correlated with attention deficit factor (r = 0.273, P = 0.035) ). There was a negative correlation between TNF-α and CBCL’s attention, discipline, aggression, extroversion and behavioral problems (r = -0.325, P = 0.011; r = -0.396, P = 0.002; r = -0.306, P = 0.017; r = -0.324, P = 0.011; r = -0.346, P = 0.007). CONCLUSIONS: High levels of IL-1β and low levels of TNF-α are present in children with ADHD. IL-1β, especially TNF-α, is associated with attention deficit disorder and some behavioral problems in children with ADHD.