目的 分析伴中央颞区棘波的儿童良性癫痫(BECT)共患注意缺陷多动障碍(ADHD)患儿认知功能改变与血清VitD表达变化的相关性,为临床上此类患儿认知损害的预防和治疗提供新思路、新方法。方法 收集2020年1月—2021年8月初次诊断的BECT共患ADHD患儿80例为研究对象,并选取同期儿保门诊体检的同龄儿童70例为对照组。采用WISC-Ⅳ评价两组儿童的认知功能,应用电化学发光法检测两组儿童血清VitD的表达水平,并将儿童血清VitD水平与WISC-Ⅳ的各项分值进行 Spearman 相关性分析。结果 与对照组比较,BECT共患ADHD组血清VitD总体水平及VitD水平正常组的VitD水平明显降低(t=4.98、8.56,P<0.05),WISC-Ⅳ结果显示,与对照组比较,BECT共患ADHD组VCI、PRI、WMI、PSI和FSIQ分值明显降低(t=12.38、17.84、13.67、11.20、15.17,P<0.05),且BECT共患ADHD组维生素D正常组、不足组和缺乏组3个亚组的VCI、PRI、WMI、PSI及FSIQ分值较对照组相应3个亚组分值明显降低(t=9.28、6.74、5.37、14.80、7.67、8.48、11.64、5.42、6.40、7.23、8.16、4.92、11.50、8.01、6.41,P<0.05)。Spearman 相关性分析显示,BECT共患ADHD患儿血清VitD水平与VCI、PRI及FSIQ分值成正相关(r=0.272、0.276、0.225,P<0.05),而与WMI、PSI分值无相关性(r=0.154、0.160,P>0.05)。结论 BECT共患ADHD患儿可出现认知功能受损,同时其血清VitD水平降低,且与部分认知功能改变成正相关。
Abstract
Objective To analyze the correlation between cognitive function and serum vitamin D(VitD) level in children with benign epilepsy with centrotemporal spikes (BECT) co-morbid with attention deficit hyperactivity disorder (ADHD), in order to provide new ideas for the prevention and treatment of the cognitive impairment for these children. Methods Eighty BECT co-morbid with ADHD children who were first diagnosed from January 2020 to August 2021 were selected as the study subjects, meanwhile seventy children with the same age who underwent physical examination were enrolled into the control group. WISC-Ⅳ was used to evaluate the cognitive function of the children in two groups. Serum VitD level was detected by elecsys. Spearman correlation analysis was adopted between serum VitD level and the scores of WISC in the two groups. Results Compared with the control group, serum VitD overall level and VitD level of the subgroup with normal VitD level in children of BECT co-morbid with ADHD group were significantly lower (t=4.98, 8.56, P<0.05). In terms of WISC-Ⅳ assessment, the VCI,PRI,WMI,PSI and FSIQ scores of BECT co-morbid with ADHD group were significantly lower than those of control group(t=12.38, 17.84, 13.67, 11.20, 15.17, P<0.05). And the scores of VCI, PRI, WMI, PSI and FSIQ in the three subgroups of BECT co-morbid with ADHD group were significantly lower than those in the control group (t=9.28, 6.74, 5.37, 14.80, 7.67, 8.48, 11.64, 5.42, 6.40, 7.23, 8.16, 4.92, 11.50, 8.01, 6.41, P<0.05). Spearman correlation analysis showed that serum VitD level was positively correlated with VCI, PRI and FSIQ scores in children with BECT and co-morbid with ADHD (r=0.272, 0.276, 0.225, P<0.05), but not significantly correlated with WMI and PSI scores (r=0.154, 0.160, P>0.05). Conclusion Children with BECT and co-morbid with ADHD may have impaired cognitive function, and their serum VitD level is decreasing, which is correlated with the change of partial cognitive function.
关键词
伴中央颞区棘波的儿童良性癫痫 /
注意缺陷多动障碍 /
认知功能 /
维生素D
Key words
benign childhood epilepsy with centrotemporal spikes /
attention deficit hyperactivity disorder /
cognitive function /
vitamin D
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基金
河北省沧州市科技计划重点研发计划项目(204106037)
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