Study on relationships of serum norepinephrine and dopamine levels with severity of children with attention deficit hyperactivity disorder
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摘要:目的 探讨多动症儿童血清去甲肾上腺素（NE）、多巴胺（DA）水平与病情严重程度的关系。方法 选取108例多动症儿童纳入研究组，另选取95例健康儿童纳入对照组。比较2组儿童血清NE、DA水平，并比较不同严重程度多动症儿童的血清NE、DA水平。采用多因素Logistic回归分析探讨儿童多动症病情严重程度的影响因素，采用Pearson相关性分析探讨多动症儿童血清NE、DA水平与病情严重程度的关系。结果 研究组血清NE、DA水平高于对照组，差异有统计学意义（P < 0.05）。重度组多动症儿童血清NE、DA水平高于轻度组、中度组，且中度组血清NE、DA水平高于轻度组，差异有统计学意义（P < 0.05）。多因素Logistic回归分析结果显示，血镁水平降低、血清NE水平升高、血清DA水平升高均为儿童多动症病情严重程度的独立危险因素（OR=2.818、4.473、3.438，P < 0.05）。多动症儿童血清NE、DA水平均与病情严重程度呈正相关（r=0.726、0.645，P < 0.05）。结论 多动症儿童血清NE、DA水平与病情严重程度密切相关，可作为评估多动症儿童病情严重程度的重要参考指标。Abstract:Objective To explore relationships of serum norepinephrine (NE) and dopamine (DA) levels in children with attention deficit hyperactivity disorder with the severity of the disease.Methods A total of 108 children with attention deficit hyperactivity disorder were selected as study group, and 95 normal children were selected as control group. The serum NE and DA levels of the two groups were compared. The serum NE and DA levels of children with different severity of attention deficit hyperactivity disorder were compared. Logistic multivariate regression analysis was used to explore the factors affecting the severity of children's illness; Pearson correlation analysis was used to explore relationships of NE and DA levels in children with attention deficit hyperactivity disorder with the severity of the disease.Results The serum NE and DA levels of the study group were significantly higher than those of the control group (P < 0.05). The levels of serum NE and DA of attention deficit hyperactivity disorder children in the severe group were higher than those in the mild group and moderate group, and were higher in the moderate group than those in the mild group(P < 0.05). Logistic multiple regression analysis showed that decreased serum magnesium level, elevated serum NE level and elevated serum DA level were independent risk factors for severity of attention deficit hyperactivity disorder in children (OR=2.818, 4.473, 3.438, P < 0.05). Serum NE and DA in children with attention deficit hyperactivity disorder were positively correlated with the severity of the disease (r=0.726, 0.645, P < 0.05).Conclusion The levels of serum NE and DA in children with attention deficit hyperactivity disorder are closely related to the severity of the disease, and can be used as important reference indexes for evaluating the severity of children with attention deficit hyperactivity disorder.
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表 1 2组儿童一般资料比较(x±s)[n(%)]
组别 n 性别 年龄/岁 身高/cm 体质量/kg 病程/年 男 女 对照组 95 72(75.79) 23(24.21) 9.15±1.48 140.21±9.73 27.42±4.35 — 研究组 108 79(73.15) 29(26.85) 8.94±1.43 138.75±8.46 27.15±4.12 2.56±1.37 
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表 2 2组儿童血清NE、DA水平比较(x±s)
pg/mL 组别 n 血清NE 血清DA 对照组 95 341.62±48.56 1.12±0.23 研究组 108 490.62±52.31* 1.47±0.38* NE: 去甲肾上腺素; DA: 多巴胺。
与对照组比较, *P < 0.05。
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表 3 不同严重程度多动症儿童血清NE、DA水平比较(x±s)
pg/mL 组别 n 血清NE 血清DA 轻度组 43 397.56±40.28 1.29±0.25 中度组 47 521.33±56.84* 1.51±0.38* 重度组 18 632.75±65.84*# 1.78±0.54*# NE: 去甲肾上腺素; DA: 多巴胺。
与轻度组比较, *P < 0.05; 与中度组比较, #P < 0.05。
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表 4 儿童多动症病情严重程度影响因素的多因素Logistic回归分析
因素 β SE Wald χ2 P OR 95%CI 血镁 1.036 0.437 5.620 0.028 2.818 1.152~5.317 血清NE 1.498 0.351 18.214 < 0.001 4.473 2.813~9.752 血清DA 1.235 0.328 14.177 0.003 3.438 2.156~7.365 NE: 去甲肾上腺素; DA: 多巴胺。
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表 5 多动症儿童血清NE、DA水平与病情严重程度的相关性分析
指标 多动症患儿病情严重程度 r P 血清NE 0.726 0.018 血清DA 0.645 0.026 NE: 去甲肾上腺素; DA: 多巴胺。
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