短暂性抽动障碍与血铅水平关系的探讨

目的探讨儿童短暂性抽动障碍与血铅水平的关系。方法 测定180例短暂性抽动症患儿及160例正常儿童的血铅浓度;将180例短暂性抽动症患儿中58例铅中毒的抽动症患儿按1：1的比例随机分成A、B两组,A组先用鹿珠合剂进行驱铅治疗,同期B组用（谷维素＋肌苷片）治疗,经一个月的治疗期后,A、B两组再交换药物治疗一个月,B组使用鹿珠合剂驱铅治疗,A组再同期使用（谷维素＋肌苷片）治疗。在每个治疗期末观察两组患者的抽动类型、抽动频率、抽动强度以及对生活的影响,采用耶鲁抽动症整体严重度量表（YGTSS）在治疗期前后对两组进行临床症状评分,并且测定各治疗期患者的血铅浓度。结果对180例短暂性抽动症患儿及160例正常儿童的血铅测定中发现,抽动症患儿平均血铅浓度为84.73μg/L,正常儿童的平均血铅浓度为49.1μg/L,抽动症患儿的血铅水平明显高于正常儿童（P〈0.05）。58例铅中毒的抽动症患儿在不同顺序治疗的治疗期末,患者的临床症状均得到改善,但血铅水平仅在鹿珠合剂驱铅治疗后有明显下降。在对血铅中毒的短暂性抽动症患儿进行鹿珠合剂驱铅治疗的过程中,血铅水平下降的同时,抽动症状也得到相应的控制。结论有短暂性抽动障碍的孩子血铅水平高于正常儿童,且血铅中毒的短暂性抽动症患儿在驱铅治疗的同时抽动症状得到相应的改善,因此儿童抽动障碍与血铅有一定的相关性。

Discussion on Relation Between Blood Lead Level and Transient Tic Disorder in Children

Objective To explore the relation between the level of blood lead and transient tic disorder(TTD) in children. Methods Blood lead level was determined in 180 children with TTD and 160 healthy children.58 children with excessive lead in 180 children with TTD were selected to randomly divide into groups A and B,with the ratio of 1:1.Group A carried out the treatment for removing lead with a mixture of Luzhu.At the same time, group B carried out the treatment with inosine tablets and oryzanol tablets.After one month treatment,groups A and B exchanged the therapy for a month.At the end of each treatment,tic type,tic frequency,the intensity of tics,and the impact on life in the patients of each group were observed.Before and after the treatment,the clinical symptoms of the two groups were evaluated and scored using Yale overall tic severity scale(YGTSS).Moreover,the children’s blood lead levels were measured in each period of the treatment. Results The average blood lead level in children with tic was 84.73ug/L.The average blood lead level in healthy children was 49.1ug/L.There was a significant difference(P<0.05).The clinical symptoms of 58 tic children with excessive lead were improved in the end of each treatment period,but their blood lead levels were reduced only after the removing lead treatment with Luzhu mixture.During the process of removing lead treatment with Luzhu mixture,blood lead level was reduced,meanwhile,tic symptoms were controlled effectively. Conclusions The average blood lead level in children with TTD is higher than that of healthy children;moreover,their clinical symptoms significantly improve with the reduced blood lead levels.Therefore,there is a positive correlation between tic disorder and blood lead level in children.