目的 分析左旋肉碱对孤独症谱系障碍(ASD)患儿的治疗效果,为ASD患儿寻求最佳治疗方案。方法 2017年9月-2018年12月选取诊断为ASD的患儿60例,随机分为治疗组和对照组各30例,对照组行常规特殊教育干预治疗,治疗组在此基础上口服左卡尼汀[100 mg/(kg·d)]。治疗前及治疗3 个月后,采用串联质谱分析检测游离肉碱含量,采用异常行为量表(ABC)、儿童孤独症评定量表(CARS)和中文版心理教育评定(C-PEP)进行量表评估。结果 治疗前,两组游离肉碱均偏低,治疗3个月后,治疗组游离肉碱均有所提升[(28.28±2.26)μmol/L],对照组仍偏低[(16.54±2.08)μmol/L];治疗3个月后两组ABC总分(t对照＝-6.32,t治疗＝-8.05)、CARS总分(t对照＝-1.24,t治疗＝-1.38)较前有所降低,PEP-3 评分较前均有所提高(t对照＝-3.584,t治疗=-4.683),差异均有统计学意义(P<0.05);治疗组ABC总分、CARS总分及PEP-3 评分与对照组比较,差异均有统计学意义(t =-4.67,-2.43,2.884,P<0.05)。结论 ASD患者口服左卡尼汀能进一步促进认知、语言和行为方面的改善。
Abstract
Objective To investigate the therapeutic effect of L-carnitine on children with autism spectrum disorder(ASD),in order to find the best treatment for ASD children. Methods Totally 60 ASD children were randomly divided into treatment group(n=30) and control group(n=30) from September 2017 to December 2018. The control group was treated with routine special education intervention,and the treatment group was given levocarnitine [100 mg/(kg·d)]. Before and 3 months after treatment,the content of free carnitine was measured by tandem mass spectrometry,and was evaluated by Abnormal Behavior Scale(ABC),Child Autism Rating Scale(CARS) and Chinese Version of Psychological Education Assessment(C-PEP). Results Before treatment,free carnitine was low in both groups. After 3 months of treatment,free carnitine in the treatment group increased to(28.28±2.26)μmol/L,but it was still low in control group [(16.54 ±2.08) μmol/L]. After 3 months of treatment,the total scores of ABC(tcontrol=-6.32, ttreatment=-8.05),CARS(tcontrol=-1.24, ttreatment=-1.38) in the two groups were significantly lower than those before treatment(P＜0.05). While the score of PEP-3 was significantly higher than before in the two groups(tcontrol=-3.584, ttreatment=-4.683,P＜0.05).The total scores of ABC,CARS and PEP-3 were significantly different between treatment group and control group(t=-4.67,-2.43,2.884,P＜0.05). Conclusion Oral administration of L-carnitine in ASD patients can further promote cognitive,linguistic and behavioral improvements.
关键词
孤独症谱系障碍 /
左旋肉碱 /
儿童
Key words
autism spectrum disorder /
L-carnitine /
children
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