CAJ | 학술논문

背景:孤独症是一种神经生物学疾病,患者血液中 5 羟色胺浓度升高被认为是该症生物学研究中最确凿的和重复性最好的研究结果之一,出生季节和母孕期母亲的情绪是否也与孤独症的发生有关 ? 目的 :比较孤独症儿童和正常儿童血浆 5 羟色胺浓度、出生季节和孕期母亲情绪的差异,探讨孤独症 5 羟色胺增高的原因. 设计:以患儿和正常儿童为研究对象的观察对比研究. 单位:一所大学医院临床心理组,湘雅二院精神卫生研究所,一所市级聋儿康复中心. 对象:孤独症组( n=54)来自中南大学湘雅二院精神卫生研究所儿童门诊和深圳市特教学校的孤独症训练班,符合 DSM IV孤独症诊断标准,儿童适应行为评定量表总分 >40;正常儿童组( n=55)来自长沙市和深圳市为幼儿园及小学的儿童,经体格检查、神经系统检查、精神状况检查、发育水平粗查,未发现明显的躯体疾病、神经系统疾病及发育延迟者. 方法:对孤独症儿童和正常儿童进行了血浆 5 羟色胺检测、并调查出生季节、孕期母亲情绪;对孤独症儿童进行适应行为评定量表评定. 主要观察指标:两组受试对象血浆 5 羟色胺水平,出生季节和母孕期母亲情绪. 结果:孤独症儿童适应行为评定量表的得分为 67.65± 1.67.孤独症儿童 5 羟色胺浓度 [(0.78± 0.32) μ mol/L]高于正常儿童 [(0.62± 0.16) μ mol/L],差异有显著性意义 (t=3.17,P=0.002). 5 羟色胺增高的孤独症儿童有 17例,与正常儿童比较,孤独症儿童冬春季出生居多,母孕期母亲情绪问题明显. 结论:孤独症儿童 5 羟色胺浓度高于正常儿童;孤独症儿童冬春季出生居多,母孕期母亲情绪问题明显;在胎儿神经发育的关键时期母体可能存在 5 羟色胺系统功能增强,可能是导致孤独症 5 羟色胺增高的原因,也许是孤独症可能的发病机制之一.
배경:고독증시일충신경생물학질병,환자혈액중 5 간색알농도승고피인위시해증생물학연구중최학착적화중복성최호적연구결과지일,출생계절화모잉기모친적정서시부야여고독증적발생유관 ? 목적 :비교고독증인동화정상인동혈장 5 간색알농도、출생계절화잉기모친정서적차이,탐토고독증 5 간색알증고적원인. 설계:이환인화정상인동위연구대상적관찰대비연구. 단위:일소대학의원림상심리조,상아이원정신위생연구소,일소시급롱인강복중심. 대상:고독증조( n=54)래자중남대학상아이원정신위생연구소인동문진화심수시특교학교적고독증훈련반,부합 DSM IV고독증진단표준,인동괄응행위평정량표총분 >40;정상인동조( n=55)래자장사시화심수시위유인완급소학적인동,경체격검사、신경계통검사、정신상황검사、발육수평조사,미발현명현적구체질병、신경계통질병급발육연지자. 방법:대고독증인동화정상인동진행료혈장 5 간색알검측、병조사출생계절、잉기모친정서;대고독증인동진행괄응행위평정량표평정. 주요관찰지표:량조수시대상혈장 5 간색알수평,출생계절화모잉기모친정서. 결과:고독증인동괄응행위평정량표적득분위 67.65± 1.67.고독증인동 5 간색알농도 [(0.78± 0.32) μ mol/L]고우정상인동 [(0.62± 0.16) μ mol/L],차이유현저성의의 (t=3.17,P=0.002). 5 간색알증고적고독증인동유 17례,여정상인동비교,고독증인동동춘계출생거다,모잉기모친정서문제명현. 결론:고독증인동 5 간색알농도고우정상인동;고독증인동동춘계출생거다,모잉기모친정서문제명현;재태인신경발육적관건시기모체가능존재 5 간색알계통공능증강,가능시도치고독증 5 간색알증고적원인,야허시고독증가능적발병궤제지일.
ACKGROUND:Autism is a kind of neurobiological disease.The increase of plasma concentration of 5 hydroxytryptamine(5 HT) is considered to be one of study results,which is the most definite and has the best repetition,for the biological investigation of autism. Whether the season of birth and maternal mood during pregnancy are correlated with the occurrence of autism? OBJECTIVE:To compare the differences of the plasma concentration of 5 HT,season of birth and the maternal mood during pregnancy between autistic and normal children,and probe into the cause of increased 5 HT in autism. DESIGN:An observational comparative study taking autistic and normal children as the subjects. SETTINGS:A clinical psychological department of a university hospital;Mental Health Institute of the Xiangya Second Hospital;A rehabilitation center for dumb children of city grade. PARTICIPANTS:Children in the autistic group(n=54),who were in accordance with the diagnostic criteria of autism in Diagnostic and Statistical Manual of Mental Disorders Fourth Edition(DSM IV) and had the total score of social adaptive ability scale(SAAS) over 40, were selected from the Outpatient Clinic for Children of the Mental Health Institute,Xiangya Second Hospital of Central South University and the training class of autism of Shenzhen Special Education School;Children in the normal control group,who had no obvious somatic and neurological diseases,and developing delay detected by physical,neurological and mental status examinations, rough detection of developing level,were selected from the primary school and kindergarten in Changsha and Shenzhen cities. INTERVENTIONS:The plasma level of 5 HT was examined, season of birth and maternal mood during pregnancy were investigated in autistic and normal children.The children with autism were accessed with SAAS. MAIN OUTCOME MEASURES:The plasma level of 5 HT,the season of birth and the maternal mood during pregnancy in both groups. RESULTS:The score of SAAS in children with autism was 67.65± 1.67.The plasma level of 5 HT was(0.78± 0.32) μ mol/L in the autistic group,which was significantly higher than that in the normal control group [(0.62± 0.16) μ mol/L](t=3.17,P=0.002). There were 17 children with autism had increased 5 HT.Compare with normal children,most children with autism were born in winter and spring,and their mother had obvious mood problems during pregnancy. CONCLUSION:The 5 HT level is higher in children with autism than in normal children.Most children with autism were born in winter and spring,and their mother had obvious emotional problems during pregnancy.There are phase of high functioning of 5 HT in mother in key period of fetus cerebra development that may be one of the causes of hyperserotonemia in autism,and that is possibly one of the etiologies of autism.