注意缺陷多动障碍患儿药物治疗前后microRNA表达量与临床症状的关系

目的 探讨注意缺陷多动障碍（ADHD）儿童药物治疗前后microRNA表达量与临床症状的关系。方法 选取2017年5月至2018年10月初诊为ADHD儿童80例为研究对象，将愿意接受药物治疗的儿童随机分为盐酸哌甲酯治疗组（n=31）和盐酸托莫西汀治疗组（n=33），不愿接受治疗的作为未治疗组（n=16），随访中盐酸哌甲酯组脱落10例，盐酸托莫西汀组脱落13例。另随机选取同时期行健康体检儿童60例作为健康对照组。ADHD儿童在首诊、随访3个月、6个月时进行SNAP-V评分，并采集ADHD及健康对照组儿童血清样本以荧光定量PCR法检测miR-4655-3p和miR-7641的相对表达量。结果 重复测量方差分析结果显示，注意力不足症状SNAP-V评分在两治疗组和未治疗组中，以及两种miRNA相对表达量在两治疗组和健康对照组中均存在分组与时间因素差异，且分组与时间因素均存在交互作用（P < 0.05）。多动冲动症状SNAP-V评分在两治疗组和未治疗组中存在时间因素差异（P < 0.05），而分组因素差异无统计学意义，且时间因素与分组因素无交互作用（P > 0.05）。经药物治疗的ADHD儿童注意力不足症状SNAP-V评分与miRNA-4655-3p和miRNA-7641相对表达量均呈负相关（分别r=-0.314、-0.495，P < 0.05）。结论 药物治疗可显著改善ADHD儿童的临床症状；血清中miR-4655-3p和miR-7641的表达水平可能作为ADHD的诊断及疗效评估的分子指标。

Association of microRNA expression before and after drug therapy with clinical symptoms in children with attention deficit hyperactivity disorder

Objective To study the association of microRNA expression before and after drug therapy with clinical symptoms in children with attention deficit hyperactivity disorder (ADHD). Methods A total of 80 previously untreated children with ADHD who were diagnosed from May 2017 to October 2018 were enrolled. The children who were willing to receive drug therapy were randomly divided into concerta-treated group with 31 children and strattera-treated group with 33 children. The children who were unwilling to receive treatment were enrolled as the untreated group with 16 children. A total of 60 children who underwent physical examination during the same period of time were enrolled as the healthy control group. SNAP-V score was determined at initial diagnosis and 3 and 6 months of follow-up. Serum samples were collected from the children with ADHD and the healthy control group. Quantitative real-time PCR was used to measure the relative expression of miR-4566-3p and miR-7641. Results The repeated measures analysis of variance showed that the SNAP-V score of attention deficit symptoms were different among the two treatment groups and the untreated group at the first visit and 3 months and 6 months after treatment (P P P P P P > 0.05), and there was no interaction between the time factor and the grouping factor (P > 0.05). The SNAP-V score of attention deficit symptoms was negatively correlated with the relative expression of miRNA-4655-3p and miRNA-7641 (r=-0.314, -0.495 respectively; P Conclusions Drug therapy can significantly improve the clinical symptoms of children with ADHD. The expression of miR-4655-3p and miR-7641 in serum can be used as biomarkers for the diagnosis and outcome evaluation of ADHD.