注意缺陷多动障碍患儿可乐定激发试验的研究  

Neuroendocrine responses to clonidine excitation in children and adolescents with attention deficit hyperactivity disorder

作　　者：苏林雁[1] 杜亚松[2] 谢光荣[1] 禹顺英[1] 黄春香[1] 李炎升[3] 

机构地区：[1]中南大学湘雅二医院精神卫生研究所,长沙410011 [2]上海市精神卫生中心 [3]中南大学湘雅二医院同位素科,长沙410011

出　　处：《中华精神科杂志》2001年第3期160-163,共4页Chinese Journal of Psychiatry

基　　金：卫生部科学研究基金资助项目 ( 94 1 12 1)

摘　　要：目的　探讨注意缺陷多动障碍 (ADHD)患儿血清生长激素 (GH)和催乳素 (PRL)水平在可乐定激发前后的变化。方法　将 47例ADHD患儿按年龄分为儿童组 (35例 ) ,青少年组 (12例 ) ,并按症状分为注意障碍亚组 (2 1例 )和多动 混合亚组 (2 6例 ) ;采用放射免疫分析法 ,于可乐定激发试验前、激发后 12 0min、180min测定GH及PRL水平的变化 ,并与 10名正常儿童 (对照组 )进行比较。结果　 (1)儿童组、青少年组与对照组间血清GH、PRL水平在试验各时点的差异均无显著性 (P >0 0 5 )。表现形式为 ,可乐定激发后 12 0min时 ,三组GH水平均高于激发前 ,PRL均低于激发前 ;激发后 180min时 ,儿童组和对照组GH下降 ,青少年组持续上升 ;儿童组PRL下降 ,青少年组和对照组回升。 (2 )ADHD多动 混合亚组 12 0min时的GH水平 [(12 2 6± 6 6 3) μg/L]高于注意障碍亚组 [(6 16±4 5 9) μg/L ;t=3 5 8,P =0 0 1) ]。结论　有多动。Objective To explore the role of monoaminutesergic mechanism in attention deficit hyperactivity disorder (ADHD), the serum growth hormone (GH) and prolactin (PRL) level were compared before and after a single oral administration of clonidine (an alpha adrenergic agent) to the children with ADHD Methods Thirty five children aged 7 11 years, 12 adolescents aged 12 16 years who met the DSM Ⅳ criteria for ADHD, and 10 normal controls aged 7 15 years were recruited ADHD subjects were divided into two subgroups: that with predominantly inattentive type (PI, n =21), and that with predominantly hyperactive impulsive and combined type(HI CT, n =26) based on the DSM Ⅳ subtype criteria The serum GH and PRL levels were determined by radioimmunoassay Results Clonidine provocation produced a rise of serum GH level and a decrease of PRL level in 120 minutes GH level descent in children and control group, and continue rise in adolescents group. PRL level continue decrease in adolescents and control group, and ascent in children in 180 min. No difference was found in the levels of GH and PRL before and 120 and 180 minutes after clonidine administration among ADHD children, adolescent and control group The serum GH level in HI CT subgroup rose to (12 26±6 63)μg/L at 120 minutes after clonidine administration, significantly higher than in PI subgroup [(6 16±4 59)μg/L, t =3 58, P =0 01] Conclusion The adrenergic receptor of ADHD children (specially those with hyperactive impulsive behavior)is more sensitive to clonidine excitation test than normal children Perhaps it is a biological marker for hyperactive impulsive behavior of ADHD children

关 键 词：轻微脑损伤综合征 可乐定 生长激素 注意缺陷多动障碍 催乳素 儿童 ADHD 

分 类 号：R749.94[医药卫生—神经病学与精神病学]