儿童孤独症外周血生物学标记物研究  

Study on biological markers of peripheral blood in children with autism

作　　者：汪鸿[1] 王小燕[1] 吴梅荣[1] 刘建琼[1] 赵职卫[1] 戴琼[1] 徐海青[1] WANG Hong;WANG Xiao Yan;WU Mei Rong;LIU Jian Qiong;ZHAO Zhi Wei;DAI Qiong;XU Hai Qing(Departments of Child Health Care, Hubei Provincial Woman and Children＇s Health Care Hospital, Wuhan 430070, Chin)

机构地区：[1]湖北省妇幼保健院儿保科,武汉430070

出　　处：《中国妇幼卫生杂志》2018年第4期15-19,共5页Chinese Journal of Women and Children Health

基　　金：中国疾病预防控制中心妇幼保健中心合生元母婴营养与健康研究项目(2017FYH015);湖北省自然科学基金重点项目(2012FFA064)

摘　　要：目的本研究旨在探索外周血淀粉酶样前体蛋白α(s APP-α)能否成为儿童孤独症早期筛查的生物学标记物。方法采用高灵敏度的酶联免疫法,比较205例孤独症患儿和健康对照儿童外周血s APP-α和脑源性生长因子(BDNF)的表达水平。采用成组T检验和多元回归统计方法探讨影响s APP-α水平的因素。结果 s APP-α在孤独症儿童病例组外周血和健康对照组儿童组间表达差异有统计学意义(P<0.001),孤独症儿童的s APP-α表达增高,且在不同程度病情的孤独症儿童之间差异有统计学意义,重度者s APP-α较轻-中度患儿增高(P<0.001),但脑源性生长因子的表达差异无统计学意义(P>0.05)。母亲年龄与s APP-α呈正相关,母亲年龄越大,s APP-α越高;出生体重和孕周与s APP-α呈负相关,出生体重越轻和孕周越小,s APP-α越高(P<0.001)。此外,新生儿高胆红素血症、新生儿缺氧缺血性脑病者s APP-α也增高。结论外周血s APP-α可能成为儿童孤独症早期筛查的实验室指标。父、母亲高龄受孕、出生体重轻、早产小孕周、新生儿高胆红素血症、新生儿缺氧缺血性脑病是s APP-α升高的影响因素。Objective The aim of the study was to explore whether plasma secreted amyloid precursor protein alpha（s APP-α）can become a possible peripheral biomarker in the diagnosis of autism. as Methods A sensitive enzyme-linked immunosorbent assay（ELISA） method was used to detect plasma s APP-α and brain derived neurotrophic factor（BDNF） in 205 children with autism and healthy children. Independent samples t-test and multiple regression were used to analyze the impact factors of s APP-α. Results There was statistically significant difference in levels of s APP-α between autistic children and healthy children（P〈 0. 001）. There was increased expression of s APP-α in autistic children. In addition,in a subset of children with severe autism,plasma level of s APP-αwas significantly higher than children with mild-to-moderate autism. However,there was no difference in BDNF between the children with severe autism and children with mild-to-moderate autism. There was a significant positive correlation between s APP-α level and the parental childbearing age,and negative correlations between s APP-α and birth weight,as well as between s APP-α and gestational weeks. Additionally, increased s APP-α was found in premature, neonatal hyperbilirubinemia and neonatal hypoxic ischemic encephalopathy（P 〈0. 05）. Conclusion Our findings support the use of s APP-α as an accurate and sensitive laboratory parameter for early screening of autism spectrum disorders（ASD）. Elder maternal age at childbearing,low birth weight,premature,neonatal hyperbilirubinemia and neonatal hypoxic ischemic encephalopathy may be responsible to the increase of s APP-α.

关 键 词：孤独症谱系障碍 生物学标记 淀粉酶样前体蛋白 脑源性生长因子 

分 类 号：R749.94[医药卫生—神经病学与精神病学]