CAJ | 학술논문

背景:抽动秽语综合征( tourette syndrome,TS)患儿的学习和社会适应能力有一定障碍,对 TS患者适应行为能力的评估,有助于弥补 TS所致的功能缺损. 目的:比较 TS患儿与正常儿童的适应行为能力,寻找进行干预的可能性. 设计:以患者和正常学生为研究对象,横断面的病例-对照,观察对比研究. 单位:一所大学医院儿科. 对象: 1999- 10/2001- 10就诊于首都医科大学附属北京安定医院儿科门诊以及住院患儿 33例(患儿组),纳入标准为符合 ICD 10 TS诊断标准的知情同意的患者.男 17例 ,女 16例.对照组为同期随机抽自北京市一普通小学 2～ 5年级学生,共 33名,男 16名 ,女 17名,无 TS、注意缺陷多动障碍、品行问题和情绪问题,经老师和家长同意后加入研究. 方法:采用儿童适应行为量表对 33例 TS患儿和 33名正常儿童进行了评定. 主要观察指标:儿童适应行为评定量表评分. 结果: TS患儿除感觉运动 (23.7± 0.6)和时空定向项目 (11.7± 3.0)与正常儿童 (23.6± 0.7,12.8± 3.2)接近外,其他分量表、因子和适应能力商数均低于正常儿童,差异有统计学显著意义( t=3.21～ 11.91,P< 0.05 ～ P< 0.01) ,且与该病的严重程度呈负相关 (r=- 0.377～ 0.661,P < 0.05～ 0.01). 结论: TS患儿的适应能力评估对 TS的严重程度的判断有重要作用 ,对治疗措施的拟订有指导意义.
배경:추동예어종합정( tourette syndrome,TS)환인적학습화사회괄응능력유일정장애,대 TS환자괄응행위능력적평고,유조우미보 TS소치적공능결손. 목적:비교 TS환인여정상인동적괄응행위능력,심조진행간예적가능성. 설계:이환자화정상학생위연구대상,횡단면적병례-대조,관찰대비연구. 단위:일소대학의원인과. 대상: 1999- 10/2001- 10취진우수도의과대학부속북경안정의원인과문진이급주원환인 33례(환인조),납입표준위부합 ICD 10 TS진단표준적지정동의적환자.남 17례 ,녀 16례.대조조위동기수궤추자북경시일보통소학 2～ 5년급학생,공 33명,남 16명 ,녀 17명,무 TS、주의결함다동장애、품행문제화정서문제,경로사화가장동의후가입연구. 방법:채용인동괄응행위량표대 33례 TS환인화 33명정상인동진행료평정. 주요관찰지표:인동괄응행위평정량표평분. 결과: TS환인제감각운동 (23.7± 0.6)화시공정향항목 (11.7± 3.0)여정상인동 (23.6± 0.7,12.8± 3.2)접근외,기타분량표、인자화괄응능력상수균저우정상인동,차이유통계학현저의의( t=3.21～ 11.91,P< 0.05 ～ P< 0.01) ,차여해병적엄중정도정부상관 (r=- 0.377～ 0.661,P < 0.05～ 0.01). 결론: TS환인적괄응능력평고대 TS적엄중정도적판단유중요작용 ,대치료조시적의정유지도의의.
BACKGROUND:Children with Tourette syndrome(TS) have certain handicaps in learning and social adaptation.An appropriate assessment of the ability of adaptive behaviors of TS children will be helpful to repair the functional impairment caused by TS. OBJECTIVE:To compare the adaptive behaviors between TS children and normal children. DESIGN:A cross sectional case controlled observational comparative study,taking TS children and normal students as the subjects. SETTING:A pediatric department of a university hospital. PARTICIPANTS:The TS group enrolled 33 TS children(17 boys and 16 girls),including the inpatients and outpatients in the Department of Pediatrics,Beijing Anding Hospital of Capital University of Medical Sciences from October 1999 to October 2001.All of them voluntarily entered the study,and they met the diagnostic criteria of the ICD 10 TS.The control group included another 33 pupils(16 boys and 17 girls) .They were randomly selected from a common primary school in Beijing. They were in grade 2 to 5,had no disorders such as TS,attention deficit hyperactivity disorder,conductive problems,and emotional problems.Informed contents were obtained from their teachers and parents. INTERVENTIONS:Thirty three TS children and 33 normal children were assessed with the children adaptive behavior scales(CABS). MAIN OUTCOME MEASURES:Scores of CABS. RESULTS:The adaptive quotients and scores of most subscales in TS children were significantly lower than those in normal controls except the scores of sensorimotor[(23.7± 0.6) vs(23.6± 0.7)]and time space orientation[(11.7± 3.00) vs(12.8± 3.2)](t=3.21 to 11.91,P< 0.05 or P< 0.01),and the low scores were negatively correlated with the severity of TS(r=- 0.377 to 0.661,P< 0.05 or P< 0.01). CONCLUSION:The assessment of adaptive behavior in TS children is an important approach to determine the severity of TS, and can also be used to guide therapy.