儿童抽动症与微量元素水平的关系研究

目的 探讨儿童抽动症(TD)与患儿体内铜、锌、铁、钙、镁、铅6种微量元素水平的关系,分析TD的危险因素,以期对今后的临床诊断和治疗提供参考资料.方法 选取2013年1月至2015年1月于保定市儿童医院就诊的196例抽动症患儿作为观察组,随机选取于本院门诊体检的健康儿童200例作为对照组.采用原子吸收分光光度仪,测量两组儿童体内铜、锌、铁、钙、镁5种微量元素水平及铅水平.运用病例对照法进行Logistic二元回归逐步分析TD与上述微量元素关系.结果 TD患儿体内的锌、铁水平均较正常儿童低(t值分别为7.711、2.691,均P<0.05),而铅水平明显比正常儿童高(t=3.596,P<0.05).不同性别的TD患儿锌、铁、铅水平之间的差异均无统计学意义(t值分别为0.911、0.891、0.896,均P>0.05),经Logistic逐步回归分析可知,锌、铁、铅水平是TD发病的相关危险因素(OR值分别为3.012、2.947、5.834,均P<0.05).微量元素铜、钙、镁在正常体检儿童体内的水平与TD患儿体内水平均无显著差异(t值分别为1.894、1.605、0.121,均P>0.05).结论 TD患儿体内锌、铁的水平低于正常儿童,而铅的水平高于正常儿童,提示儿童体内的微量元素失衡是抽动症发生的危险因素.

Relationship between trace elements levels in children and Tic disorders

Objective To investigate the relationship between Tic disorders ( TD ) and trace elements levels of copper, zinc, iron, calcium, magnesium and lead in children and analyze the risk factors of TD so as to provide reference for future clinical diagnosis and treatment.Methods From January 2013 to January 2015 totally 196 children with TD treated in Baoding Children' s Hospital were selected as observation group and 200 healthy children taking physical examination at outpatient department of the hospital were randomly selected as control group.Atomic absorption spectrophotometer was used to measure the levels of copper, zinc, iron, calcium, magnesium and lead. Logistic binary regression stepwise analysis was used to explore the relationship between TD and the above trace elements.Results The levels of zinc and iron in TD children were lower than normal children (t value was 7.711 and 2.691, respectively, both P<0.05), but the level of lead was significantly higher (t=3.596, P<0.05).There were no differences between TD children of different genders in levels of zinc, iron and lead (t value was 0.911, 0.891 and 0.896, respectively, all P>0.05).Logistic regression analysis showed that zinc, iron and lead levels were the risk factors of TD incidence (OR value was 3.012, 2.947 and 5.834, respectively, all P<0.05).The levels of copper, calcium and magnesium in TD children and normal children were not significantly different ( t value was 1.894, 1.605 and 0.121, respectively, all P>0.05).Conclusion The levels of zinc and iron are lower but the level of lead is higher in TD children than in normal children, which suggests that the imbalance of trace elements in children is a risk factor of TD occurrence.