儿童孤独症血浆5-羟色胺的测定

目的 比较孤独症儿童和正常儿童血浆5-羟色胺(5-HT)的浓度,探索5-HT浓度增高和5-HT浓度正常的孤独症儿童各自的临床特点。方法 采用孤独症行为评定量表(ABC)、儿童期孤独症评定量表(CARS)和适应行为评定量表对33例孤独症儿童进行评定,并进行了血浆5-HT检测,以高出正常儿童平均5-HT浓度1.67个标准差的孤独症儿童为5-HT增高组,其他孤独症儿童为5-HT正常组,比较两组孤独症儿童的临床特征。结果 孤独症儿童的ABC得分为72.30±29.91、CARS的得分为41.83±4.05、适应行为评定量表的得分为66.55±12.52。孤独症儿童5-HT浓度为0.77±0.33μmol/L;正常儿童5-HT浓度为0.62±0.18μmol/L,两组经t检验有显著性差异(t=2.23;P=0.03)。5-HT增高的孤独症儿童有9例,5-HT正常的孤独症儿童有24例,两组临床特征比较未发现明显差异。结论 27.3％的孤独症儿童5-HI浓度增高,5-HT增高与5-HT正常的儿童孤独症临床特征相同。孤独症的病因可能是异质性的。     

伴与不伴抑郁情绪孤独症谱系障碍静息态脑功能磁共振成像差异研究北大核心CSCD

目的探讨伴与不伴抑郁情绪孤独症谱系障碍(autistic spectrum disorder,ASD)患儿静息态脑功能磁共振成像特征的差异及与其临床特征的相关性,从脑功能角度了解ASD患儿伴发抑郁情绪的病理机制。方法前瞻性地收集20例伴抑郁的ASD患儿、25例不伴抑郁的ASD患儿及25名正常发育(typical development,TD)儿童的一般人口学资料,并使用儿童孤独症评定量表和儿童抑郁量表对ASD症状和抑郁症状进行评估,采集所有被试的大脑T1像结构磁共振数据和静息态功能磁共振数据,计算自动解剖标记(automated antomical labeling,AAL)模板中90个脑区的局部一致性值(regional homogeneity,ReHo)。比较三组脑区ReHo值并分析差异脑区的ReHo值与临床特征相关性。结果基于ReHo值的比较分析显示:与TD组相比,伴抑郁ASD组额叶差异区域主要分布于默认网络、听觉网络、感觉运动区域、注意网络(P<0.001,经AlphaSim校正),颞叶差异脑区主要分布于听觉网络(P<0.001,经AlphaSim校正),顶叶差异区域主要分布于默认网络、感觉运动区域(P<0.001,经AlphaSim校正);与TD组相比,不伴抑郁ASD组额叶差异区域主要分布于听觉网络(P<0.001,经AlphaSim校正),顶叶差异区域主要分布于默认网络、注意网络(P<0.001,经AlphaSim校正);与不伴抑郁ASD组相比,伴抑郁ASD组差异脑区主要分布于感觉运动区域、注意网络(P<0.001,经AlphaSim校正)。伴抑郁ASD组右侧额中回(眶部)ReHo值与儿童孤独症评定量表总分(r=0.631,P=0.003)和儿童抑郁量表总分(r=0.656,P=0.002)呈正相关。结论伴抑郁情绪ASD的发生与大脑广泛区域功能下降相关,尤其是感觉运动区域及注意网络功能下降。     

儿童孤独症的血浆谷氨酸和γ-氨基丁酸水平及其与伴发癫痫的关系

目的 探讨血浆谷氨酸(Glu)和γ-氨基丁酸(GABA)水平异常与儿童孤独症的关系,及其在儿童孤独症易发癫痫病理机制中的作用.方法 从已经收集血样的儿童孤独症患者库(278例)中随机选择34例为总的患者组,其中不伴癫痫者30例(不伴癫痫组),伴癫痫者4例;而此库中所有伴发癫痫的27例患者为伴癫痫组,正常儿童36名为对照组.采用高效液相色谱法测定血浆Glu和GABA水平并进行上述3组间的比较.结果 孤独症患者伴发癫痫的比例为9.7%(27/278).总患者组的血浆Glu和GABA水平与对照组的差异均无统计学意义(t=1.09,P:0.28;t=0.56,P=0.58).两两比较:伴癫痫组血浆Glu水平显著高于不伴癫痫组和对照组(H=8.93,P=0.003;H=10.65,P=0.001),而后两组间的差异无统计学意义(H=0.00,P=1.00);此3组间血浆GABA水平差异无统计学意义(H=5.38,P=0.07,df=2).Pearson相关分析显示,患者组的血浆Glu及GABA水平分别与性别、年龄、病程、孤独症行为评定量表(Autism Behavior Checklist,ABC)评分等的相关均无统计学意义(P＞0.05).结论 仅在伴发癫痫的孤独症儿童中发现血浆Glu水平的异常增高,这可能是孤独症易发癫痫的病理机制之一.     

孤独症治疗评定量表中文版的信度和效度检验

目的 分析孤独症治疗评定量表（ATEC）中文版的信度和效度,并评价ATEC中文版评分与孤独症症状和发育水平的相关性。 方法 入组2016年6月-2018年12月在南京医科大学附属脑科医院就诊、符合《精神障碍诊断与统计手册(第5版)》（DSM-5）孤独症谱系障碍（ASD）诊断标准的77例儿童作为病例组,招募健康儿童71名作为对照组。采用ATEC中文版、孤独症行为量表（ABC）、儿童孤独症评定量表（CARS）、孤独症诊断访谈量表修订版（ADI-R）、Gesell发育量表评定病例组儿童的临床症状和发育水平;对照组儿童完成ATEC中文版评定。采用Cronbach’s α系数评估ATEC中文版的信度,采用ROC曲线评估其效度。 结果 ATEC中文版总量表及其各分量表的Cronbach’s α系数在0.750~0.787之间。ATEC中文版总量表及其分量表的敏感度在0.922~0.987之间,特异度在0.803~0.887之间,曲线下面积在0.924~0.972之间。ATEC中文版总评分与CARS和ABC总评分呈正相关（r=0.509、0.580,P均<0.01）;ATEC中文版的表达/语言/沟通、社交能力、感知/认知能力分量表评分与Gesell发育量表对应分量表的发育商均呈负相关（r=-0.677、-0.383、-0.332,P均<0.01）。 结论 ATEC中文版具有较高的信度和效度,且其评分能反映ASD症状的严重程度及患儿发育水平。     

儿童孤独症早期干预效果及影响因素研究

目的 探讨早期综合干预对儿童孤独症的效果及影响因素.方法 对82例孤独症儿童采取综合干预,干预前后分别应用儿童孤独症评定量表（CARS）、0-6岁儿童神经心理发育量表、儿童孤独症及相关发育障碍心理教育量表修订版（C-PEP）进行测查.结果 CARS量表评分干预后显著低于干预前（p=0.000）;发育商干预后显著高于干预前（P=0.000）;干预后C-PEP的功能发展量表中所有项目评分及发展总分均较干预前显著升高,病理学量表中所有项目评分均较干预前显著下降（P＜0.01）.多元逐步回归分析结果显示,38项自变量中的6项进入CARS评分变化的回归方程（P＜0.05）,9项进入发育商变化的回归方程（P＜0.05）.结论 早期综合干预能有效减轻孤独症患儿的病理症状,提升发育水平.     

孤独症谱系障碍儿童胃肠问题与核心症状及预后的相关分析

目的旨在探讨孤独症谱系障碍(ASD)儿童胃肠问题与临床核心症状及预后的关系,为ASD的诊断和预后提供线索。方法纳入98例ASD儿童(ASD组)和103例发育正常的健康儿童(HC组)。评估两组儿童是否存在胃肠问题;ASD组根据是否存在胃肠问题分为胃肠道阳性组(GI+组)和胃肠道阴性组(GI-组),分别予以儿童孤独症评定量表(CARS)、孤独症儿童行为检查量表(ABC)评估患儿核心症状。经过行为康复治疗后,再次给予GI+组儿童以上量表进行评估。结果 ASD组胃肠问题的发生率明显高于HC组(P0.05);GI+组和GI-组CARS量表评分差异有统计学意义(P=0.005);胃肠症状好转的患儿治疗后儿童孤独症评定量表评分显著低于无好转者,也显著低于治疗前儿童孤独症评定量表评分(P0.05);胃肠症状加重时患儿精神症状多加重。结论 ASD组胃肠问题发生率较高,积极干预胃肠道症状可能有利于ASD的治疗,且胃肠道症状可作为预测ASD儿童病情变化的一个指标。     

每周综合训练对孤独症的疗效分析

目的 探讨每周15小时的综合训练在短期内对孤独症的疗效。方法 以63例孤独症儿童为研究对象。依据儿童期孤独症评定表（Childhood Autism Rating Scale,CARS）评分将其分为轻-中度组、重度组,运用综合训练包括应用行为分析（applied behavior analysis,ABA）疗法、社交游戏团体训练、感觉统合训练、家长指导教育对患儿进行每周15小时的训练,持续6个月。于训练前、训练3月后、训练6月后用儿童孤独症治疗评定量表（Autism Treatment Evaluation Checklist,ATEC）及感觉统合发展评定量表（sensory integrative schedule,SIS）对患儿进行评估。通过单因素重复测量方差分析法对评估数据进行分析。结果 训练6月后,全组ATEC总分有显著改善（F=31.88,P<0.001）。轻-中度组ATEC总分两两比较有显著性改善（F=16.57,P<0.001）;重度组ATEC总分两两比较有显著改善（F=15.45,P≤0.001）。全组前庭失衡无显著改变,触觉防御、本体感均有显著改善（P≤0...     

Ⅰ、Ⅱ型精神分裂症病人血铜锌超氧化物歧化酶含量变化研究

采用双抗体放免法测定了精神分裂症病人121例(Ⅰ型77例,Ⅱ型44例)和健康对照者128人的血 CuZn-SOD。结果显示精神分裂症血 CuZn-SOD 含量显著高于对照组(t=12.34,P<0.001)。其中Ⅰ型较Ⅱ型病人显著增高(t=13.93,P<0.001)。前者治疗后酶含量明显下降(t=7.715,P<0.001),后者无明显变化(t=0.541,P>0.05)。     

奥氮平治疗儿童孤独症的临床研究

目的　研究奥氮平对儿童孤独症的疗效及其副作用。方法　用奥氮平对 17例 1岁半～ 8岁符合CCMD - 3诊断的孤独症患者进行治疗 ,剂量为 2 .5～ 10mg/d ,连续用药并观察 12周。由 2位精神科医生同时在治疗前和治疗后第 2、4、6、8、12周采用临床疗效总评量表、儿童孤独症评定量表及临床记录对患者进行评定 ,评估其病情严重程度及奥氮平的疗效和副反应。结果　 2位精神科医生所得出得评定结果是相一致的 (Kappa =0 .86 )。从用药后第 6周起 ,临床疗效总评量表中的病情严重程度因子分值与治疗前相比明显降低 ,而总体疗效分值明显升高 ,二者均具有统计学差异 (P <0 .0 5 ) ;而CARS评定分值的降低也具有统计学意义 ,提示奥氮平对儿童孤独症有较好的疗效。治疗后 12周的评定结果与治疗后 6周的结果比较仍具有统计学差异 (P <0 .0 1) ,提示疗程的延长能提高疗效。奥氮平可显著改善易激惹症状、精神病性症状及睡眠障碍 ,对于刻板的行为模式、自伤行为、活动过度和注意力不集中也有一定效果。副反应出现极少 ,主要为可控性的体重增加以及强迫症状。结论　奥氮平治疗儿童孤独症是安全有效的 ,尤其对于易激惹、精神病性症状及睡眠障碍疗效较好。     

儿童孤独症血浆5-羟色胺水平的对照研究

目的：通过检测血浆5—羟色胺(5—HT)水平，初步探讨儿童孤独症的生化病理机制。方法：采用放射免疫方法定量检测54例儿童孤独症患儿(病例组)及26名健康儿童(对照组)的血浆5—HT水平，并作比较。结果：病例组的血浆5—HT水平显著高于对照组，但与疾病的严重程度无明显相关。结论：提示高5—HT可能是儿童孤独症生物学标志。     

Predictors of trait aggression in bipolar disorder

OBJECTIVES: Although aggressive behavior has been associated with bipolar disorder (BD), it has also been linked with developmental factors and disorders frequently found to be comorbid with BD, making it unclear whether or not it represents an underlying biological disturbance intrinsic to bipolar illness. We therefore sought to identify predictors of trait aggression in a sample of adults with BD. METHODS: Subjects were 100 bipolar I (n = 73) or II (n = 27) patients consecutively evaluated in the Bipolar Disorders Research Program of the New York Presbyterian Hospital-Payne Whitney Clinic. Diagnoses were established using the Structured Clinical Interview for the DSM-IV (SCID-I) and Cluster B sections of the SCID-II. Mood severity was rated by the Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS). Histories of childhood maltreatment were assessed via the Childhood Trauma Questionnaire (CTQ), while trait aggression was measured by the Brown-Goodwin Aggression Scale (BGA). RESULTS: In univariate analyses, significant relationships were observed between total BGA scores and CTQ total (r = 0.326, p = 0.001), childhood emotional abuse (r = 0.417, p < 0.001), childhood physical abuse (r = 0.231, p = 0.024), childhood emotional neglect (r = 0.293, p = 0.004), post-traumatic stress disorder (t = -2.843, p = 0.005), substance abuse/dependence (t = -2.914, p = 0.004), antisocial personality disorder (t = -2.722, p = 0.008) and borderline personality disorder (t = -5.680, p < 0.001) as well as current HDRS (r = 0.397, p < 0.001) and YMRS scores (r = 0.371, p < 0.001). Stepwise multiple regression revealed that trait aggression was significantly associated with: (i) diagnoses of comorbid borderline personality disorder (p < 0.001); (ii) depressive symptoms (p = 0.001); and (iii) manic symptoms (p < 0.001). CONCLUSIONS: Comorbid borderline personality disorder and current manic and depressive symptoms each significantly predicted trait aggression in BD, while controlling for confounding factors. The findings have implications for nosologic distinctions between bipolar and borderline personality disorders, and the developmental pathogenesis of comorbid personality disorders as predisposing to aggression in patients with BD.     

Autism in visually impaired individuals

The aim of the present study was to assess the prevalence and associated risk factors of autism in a sample of visually impaired children and adolescents. A total of 257 blind children and adolescents (age range: 7-18 years) were examined for autism using a three-stage process. The first stage estimated probable cases of autistic disorder based on the Autism Behavior Checklist and the second stage by direct observation of the subjects in different settings. In the third stage, subjects with the probable diagnosis of autistic disorder were asked to undergo psychiatric examination. A final diagnosis of autistic disorder (based on the criteria in DSM-IV) was given after interviewing the caregivers and clinical observation. Thirty of 257 subjects met the criteria for autistic disorder. Comparison of the characteristics of the two groups (autistic and non-autistic) with chi2-squared and independent sample t-tests revealed a statistically significant difference in terms of severity of blindness (P = 0.015), cerebral palsy (P = 0.02) and intellectual level (P = 0.001). The results of the present study suggest that subjects with blindness plus autism have greater neurological impairment (as suggested by the presence of lower intellectual level and cerebral palsy), and more severe visual impairment than the subjects with blindness only.     

Altered chemical metabolites in the amygdala-hippocampus region contribute to autistic symptoms of autism spectrum disorders.

BACKGROUND: Although several previous studies have been conducted, the neural basis of autism spectrum disorder (ASD) is poorly understood. The objective of the present study was to determine whether individuals with ASD have altered brain chemical metabolites and whether such alterations are related to their autistic symptoms. METHODS: N-acetylaspartate (NAA)/creatine (Cr) and choline/Cr ratios in the right medial temporal lobe (MTL), medial prefrontal cortex, and cerebellar vermis were measured in 38 individuals with ASD (mean age = 12.9 years), including 12 with autism, 15 with Asperger's Disorder, and 11 with pervasive developmental disorder not otherwise specified (PDD-NOS), and 16 matched healthy control subjects (mean age = 11.5 years) with proton magnetic resonance spectroscopy. Autistic symptoms were assessed by the Childhood Autistic Rating Scale-Tokyo Version. RESULTS: There was a significant group difference for NAA/Cr ratio in the right MTL between the autism, Asperger's Disorder, PDD-NOS, and control groups (p < .001), and the autism group had a significantly lower NAA/Cr ratio compared with the PDD-NOS (p < .001) and control (p < .001) groups. In the ASD group, there was a significant negative correlation between NAA/Cr ratio in the right MTL and their Childhood Autistic Rating Scale-Tokyo Version total scores (r = -.44, p = .01) and subscales of emotional response (r = -.38, p = .02) and listening response (r = -.54, p = .001). CONCLUSIONS: The results of the present study suggest that subjects with ASD have abnormalities of neural integrity in the amygdala-hippocampus region that are related to their severity and social impairments.     

双相障碍抑郁发作患者认知功能损害及与听觉P300改变的关系

目的:探讨双相障碍抑郁发作患者认知功能损害和听觉P300变化的关系.方法:采用重复性神经心理状态测验(RBANS)及听觉诱发电位检测方法对43例首次发病未服药的双相障碍抑郁发作患者(病例组)及45名健康志愿者(对照组)进行认知功能及P300指标检测;结果 进行组间比较和分析.采用汉密尔顿抑郁量表(HAMD)评估病例组患...     

Nocturnal excretion of 6-sulphatoxymelatonin in children and adolescents with autistic disorder.

BACKGROUND: Many studies in autistic disorder report sleep problems and altered circadian rhythms, suggesting abnormalities in melatonin physiology. Additionally, melatonin, a pineal gland hormone produced from serotonin, is of special interest in autistic disorder given reported alterations in central and peripheral serotonin neurobiology. METHODS: Nocturnal urinary excretion of 6-sulphatoxymelatonin was measured by radioimmunoassay in groups of children and adolescents with autistic disorder (n = 49) and normal control individuals (n = 88) matched on age, sex, and Tanner stage of puberty. RESULTS: Nocturnal 6-sulphatoxymelatonin excretion rate was significantly and substantially lower in patients with autism than in normal controls (mean +/- SEM, .75 +/- .11 vs. 1.80 +/- .17 microg/hr, p =.0001), and was significantly negatively correlated with severity of autistic impairments in verbal communication and play (p < .05). CONCLUSIONS: These findings indicate clearly that nocturnal production of melatonin is reduced in autism. Further research is warranted in order to understand the mechanisms underlying the lower melatonin production, to assess the impact of altered melatonin on the pathophysiology and behavioral expression of autistic disorder, and to determine the utility of melatonin administration in individuals with autism.     

Low platelet-poor plasma levels of serotonin in adult autistic patients

BACKGROUND: Hyperserotonemia has been reported in about a third of autistic patients. However, most studies have examined whole blood levels of serotonin (5-HT), the vast majority of which is found in platelets. The aim of this study was to determine 5-HT levels in platelet-poor plasma (PPP) in a group of adult patients with autism. METHODS: Levels of PPP 5-HT were compared between 10 adult drug-free autistic patients and 12 healthy controls. The Ritvo-Freeman Real-Life Rating Scale and the Overt Aggression Scale (OAS) were administered to the autistic group as a measure of symptom severity. RESULTS: Significantly lower PPP 5-HT levels were observed in the autistic group as compared to the controls (p = 0.03). In addition, PPP 5-HT levels were inversely correlated with OAS scores among subjects with autism (r = -0.64, p < 0.05). CONCLUSION: PPP 5-HT ('free') levels appear to be low in autistic patients and may play a role in the pathophysiology and symptomatology of the disorder.     

脑卒中后睡眠障碍患者血清NSE IL-1β及5-HT水平的变化及意义

目的探讨脑卒中后睡眠障碍患者血清神经元特异性烯醇化酶(NSE)、白细胞介素-1β(IL-1β)及5-羟色胺(5-HT)水平的变化及意义。方法选取200例脑卒中患者为研究对象,根据匹斯堡睡眠质量指数(PSQI)评分分为睡眠障碍组(SD组,PSQI评分7~14分)和无睡眠障碍组(non-SD组,PSQI评分15~21分)。对比2组血清NSE、IL-1β、5-HT水平,探讨血清NSE、IL-1β、5-HT表达情况与脑卒中后睡眠障碍的关系。结果200例脑卒中患者中出现睡眠障碍56例,发生率为28.00%。SD组患者血清NSE、IL-1β水平及NIHSS评分均显著高于non-SD组(t=7.880、9.405、5.814,P<0.05),而SD组血清5-HT水平低于non-SD组(t=8.789,P<0.05)。随着睡眠障碍程度的加重,患者血清NSE、IL-1β水平明显升高(t=4.184、3.774,P<0.05),而血清5-HT水平降低(t=3.167,P<0.05)。睡眠障碍患者血清NSE、IL-1β水平与PSQI评分呈显著正相关(r=0.341、0.363,P<0.05),而血清5-HT水平与PSQI评分呈负相关(r=0.438,P<0.05)。Logistic回归分析显示,NIHSS评分高(OR=1.367,95%CI 1.018~1.835,P<0.05)、血清NSE(OR=1.386,95%CI 1.120~1.716,P<0.05)与IL-1β(OR=1.149,95%CI 1.063~1.243,P<0.05)高表达及血清5-HT(OR=0.770,95%CI 0.667~0.889,P<0.05)低表达是脑卒中后睡眠障碍的危险因素(P<0.05)。结论脑卒中后睡眠障碍的发生率较高,神经递质分泌失调和炎症反应是导致脑卒中后睡眠障碍的重要原因。     

慢性失眠患者血清神经营养因子改变及其与睡眠质量和认知功能的关系

目的探讨慢性失眠患者血清脑源性神经营养因子(BDNF)和胶质源性神经营养因子(GDNF)水平的变化及其与睡眠质量和认知功能间的关系。方法纳入2017年5月至2018年7月安徽医科大学附属巢湖医院睡眠障碍科就诊的慢性失眠患者57例,以同期本院健康体检中心的30名健康体检者作为对照。采用匹兹堡睡眠质量指数(PSQI)评估受试者的失眠程度(部分慢性失眠患者接受整夜多导睡眠监测),采用蒙特利尔认知评估量表(MoCA)评估总体认知功能,采用九盒迷宫评估特殊记忆功能,ELISA检测受试者的血清BDNF和GDNF水平。结果慢性失眠患者的PSQI得分显著高于对照组[慢性失眠组(14.0±2.2)分,对照组(3.9±1.1)分;t=28.093,P<0.01],MoCA评分显著低于对照组[慢性失眠组(24.5±3.6)分,对照组(26.5±0.9)分;t=-2.985,P<0.01],同时物体工作[慢性失眠组1.0(0,1.0),对照组0(0,0.3)]、空间工作[慢性失眠组3.0(2.0,4.0),对照组1.0(1.0,2.0)]、物体再认记忆[慢性失眠组0(0,0),对照组0(0,0)]错误数高于对照组(Z=-2.896、-5.007、-2.306,均P<0.05)。慢性失眠患者血清BDNF[慢性失眠组(19.48±7.50)ng/ml,对照组(46.49±13.33)ng/ml]和GDNF[慢性失眠组(32.76±14.04)pg/ml,对照组(59.63±20.30)pg/ml]水平显著低于对照组(t=-10.274、-7.240,均P<0.01),与PSQI得分呈负相关(r=-0.293、-0.320,均P<0.05),与MoCA评分呈正相关(r=0.331、0.295,均P<0.05)。BDNF还与病程和空间工作记忆错误数呈负相关(r=-0.319、-0.393,均P<0.05),GDNF与多导睡眠监测中总睡眠时间呈正相关(r=0.520,P<0.05)。结论慢性失眠患者的血清BDNF和GDNF水平较正常人降低,并与其睡眠质量和认知功能损害相关。     

游离脂肪酸与老年2型糖尿病患者轻度认知功能障碍的研究

目的探讨游离脂肪酸(FFA)与老年2型糖尿病(T2DM)患者轻度认知功能障碍(MCI)的关系。方法选择85例老年T2DM患者,应用蒙特利尔认知评估(MoCA)量表评定认知功能,分为T2DM认知功能正常组(T2DM-NC)45例和T2DM认知功能障碍组(T2DM-MCI)40例,另选择糖耐量正常且认知功能正常者35例为对照组(NC)。测定3组FFA、糖化血红蛋白(HbA1c)、血脂等。结果 T2DM-MCI组FFA水平(7.45±0.13)mmol/L高于T2DM-NC组(6.32±0.13)mmol/L及NC组(4.56±0.11)mmol/L。T2DM-MCI患者的MoCA评分与糖尿病病程(r=-0.507,P=0.001)、FPG(r=-0.581,P0.001)、HOMA-IR(r=-0.360,P=0.022)、HbA1c(r=-0.533,P0.001)、TC(r=-0.358,P=0.023)、TG(r=-0.408,P=0.009)、LDL-C(r=-0.377,P=0.016)、FFA水平(r=-0.566,P0.001)呈负相关,与HDL-C(r=0.365,P=0.021)呈正相关。多重线性回归分析结果示,FPG(β=-0.290,P=0.015)、HbA1c(β=-0.272,P=0.019)、FFA(β=-0.375,P=0.001)、病程(β=-0.248,P=0.037)是MoCA评分的危险因素。结论血清FFA是T2DM患者MCI的危险因素。     

Behavioural symptoms and autistic psychosis in the mentally retarded adult

302 mentally retarded (MR) adults, representative of the total Danish MR population, were examined with regard to behavioural symptoms and psychiatric disorder. Deviant behaviour was found in 123 (41%) and was correlated to origin and degree of retardation, epilepsy and place of living. The distribution of the symptoms strongly indicates that organic brain damage is the major etiological cause. By grouping behavioural symptoms on three axes: A: social withdrawal (27%), B: abnormal bodily movements and sensory stimulation (22%) and C: conduct behaviour (17%), different patterns of abnormal behaviour were demonstrated. Behavioural symptoms occurred in 74 (87%) of 85 persons given present state psychiatric diagnoses. Behavioural symptoms are prominent in the group of autistic psychosis (childhood autism), which is classified by the triad of 1) autism, 2) abnormal language, and 3) stereotypic behaviour. This diagnosis was established in 23 (7.6%), and differences in psychopathology are basically determined by degree of intellectual resources, with the subgroup of Kanner's early childhood autism constituting the upper level.