阿立哌唑联合氟哌啶醇治疗小儿多发性抽动症的临床效果及对抗链球菌溶血素O水平的影响  

Clinical effect of aripiprazole combined with haloperidol in the treatment of Tourette's syndrome in children and its influence on level of antistreptolysin O

作　　者：殷菡 尚红梅 孙海燕 YIN Han;SHANG Hong-mei;SUN Hai-yan(Department of Pediatrics,West Campus of Qingdao Municipal Hospital,Qingdao Shandong 266000,China)

机构地区：[1]青岛市立医院西院区儿科,山东青岛266000

出　　处：《临床和实验医学杂志》2021年第14期1489-1493,共5页Journal of Clinical and Experimental Medicine

基　　金：山东省自然科学基金项目(编号:20147HL072)。

摘　　要：目的探讨阿立哌唑联合氟哌啶醇治疗小儿多发性抽动症的临床效果及对抗链球菌溶血素O(ASO)水平的影响。方法前瞻性选取2018年1月至2019年1月青岛市立医院收治的200例多发性抽动症患儿,按随机数字表法分为2组,每组各100例。对照组患儿给予阿立哌唑治疗,2次/d,初始计量为2.5 mg,每隔1周增加2.5 mg,但最大用药剂量不能超过10 mg。研究组在对照组基础上给予氟哌啶醇治疗,2次/d,初始计量为0.25 mg,每隔1周增加0.25 mg,但最大用药剂量不能超过6 mg。7 d为1个疗程,2组患儿连续治疗4个疗程。比较2组治疗效果、发声抽动与运动抽动YGTSS评分、肌肉功能(抽动强度、抽动频率、抽动次数)、社会功能(学校情况、活动情况、社交情况)、神经功能与ASO水平。结果研究组治疗有效率为98.0%,显著高于对照组(91.0%),差异有统计学意义(P<0.05)。治疗后4周,研究组发声抽动与运动抽动YGTSS评分分别为(2.2±1.7)、(2.2±1.7)分,均显著低于对照组[(4.5±1.9)、(6.5±2.4)分],差异均有统计学意义(P<0.05)。治疗后4周,研究组肌肉抽动强度与频率为1.3±0.7、1.2±0.6,均小于对照组(2.5±1.2、2.6±1.0),抽动次数为(1.1±0.9)次,少于对照组[(2.3±1.0)次],差异均有统计学意义(P<0.05)。治疗后4周,研究组社会功能评分均高于对照组,差异均有统计学意义(P<0.05)。治疗后4周,研究组NE、GABA水平为(33.8±4.5)IU、(2.5±1.6)KJ,显著高于对照组[(28.6±4.1)IU、(1.8±1.4)KJ],5-HT、DA、ASO水平分别为(4.3±1.8)mg/d、(56.7±18.2)ng/L、(102.6±7.3)IU/mL,低于对照组[(5.2±2.4)mg/d、(65.2±15.5)ng/L、(113.5±8.4)IU/mL],差异均有统计学意义(P<0.05)。结论对多发性抽动症进行阿立哌唑联合氟哌啶醇治疗,效果理想,可改善患儿肌肉功能与神经功能,降低抽动与运动抽动YGTSS评分、ASO水平,提高社会功能。因此,阿立哌唑联合氟哌啶醇治疗小儿多发抽动症值得广泛应用。Objective To investigate the clinical effect of aripiprazole combined with haloperidol in the treatment of Tourette's syndrome in children and its influence on level of antistreptolysin O(ASO).Methods A total of 200 children with Tourette's syndrome admitted to Qingdao Municipal Hospital from January 2018 to January 2019 were prospectively selected and randomly divided into two groups according to the random number table method,each group with 100 cases.The control group was treated with aripiprazole twice a day,the initial dose was 2.5 mg,and the increase was 2.5 mg every other week,but the maximum dose could not exceed 10 mg.The study group was given haloperidol on the basis of the control group,twice a day,with the initial dose of 0.25 mg and an increase of 0.25 mg every 1 week,but the maximum dose should not exceed 6 mg.Seven days as a course of treatment,the 2 groups of children were treated for 4 consecutive courses.The treatment effect,YGTSS score,muscle function(twitch intensity,twitch frequency,twitch times),social function(school situation,activity situation,social situation),nerve function and ASO level of the two groups were compared.Results The effective rate of treatment in the study group was 98.0%,which was significantly higher than that in the control group(91.0%),and the difference was statistically significant(P<0.05).Four weeks after treatment,the YGTSS scores for vocal tics and motor tics in the study group were(2.2±1.7)and(2.2±1.7)points,respectively,which were significantly lower than those of the control group[(4.5±1.9),(6.5±2.4)points],the differences were statistically significant(P<0.05).Four weeks after treatment,the intensity and frequency of muscle twitches in the study group were 1.3±0.7 and 1.2±0.6,which were less than those in the control group(2.5±1.2,2.6±1.0),and the number of twitches was(1.1±0.9)times,which was less than the control group[(2.3±1.0)times],the differences were statistically significant(P<0.05).Four weeks after treatment,the social function scores of th

关 键 词：小儿多发性抽动症 阿立哌唑 氟哌啶醇 临床效果 抗链球菌溶血素O 

分 类 号：R749.94[医药卫生—神经病学与精神病学]