二十二碳六烯酸对注意缺陷多动障碍儿童临床疗效、血清胶质源性神经营养因子及炎症因子水平的影响  

Effects of docosahexaenoic acid on clinical efficacy and glial-derived neurotrophic factor and inflammatory cytokines in children with attention-deficient hyperactivity disorder

作　　者：乔娟 熊子珺 苏邹 陈红源 QIAO Juan;XIONG Zi-jun;SU Zou;CHEN Hong-yuan(Department of Psychiatry,Wudong Hospital,Wuhan 430084,China)

机构地区：[1]武汉市武东医院精神科,430084 [2]武汉市武东医院检验科,430084

出　　处：《临床精神医学杂志》2022年第1期21-25,共5页Journal of Clinical Psychiatry

基　　金：2021年武汉市医学科研项目(WX21Z69)。

摘　　要：目的:研究二十二碳六烯酸(DHA)对注意缺陷多动障碍(ADHD)儿童临床疗效、血清中胶质源性神经营养因子(GDNF)及炎症因子水平的影响。方法:118例ADHD儿童随机分为研究组(60例)与对照组(58例)。研究组给予盐酸哌甲酯与DHA 300 mg/d,对照组给予盐酸哌甲酯与空白安慰剂,治疗8周。在基线及治疗8周后,采用注意缺陷多动障碍SNAP-IV评定量表(中文版)(SNAP-IV)、美国康纳简易多动症行为评价量表(Conner)评估ADHD儿童病情,记录不良反应;检测两组DHA、GDNF、白介素(IL)-1β、IL-6、肿瘤坏死因子α(TNF-α)水平。结果:8周治疗后,两组SNAP-IV总分、注意缺陷分、Conner学习、心身、多动指数评分下降幅度差异具有统计学意义(P<0.05或P<0.01)。研究组DHA、GDNF水平显著高于对照组及治疗前,而IL-6、TNF-α水平显著低于对照组及治疗前(P<0.05或P<0.01)。研究组ΔDHA与ΔSNAP-IV总分呈负相关;ΔGDNF与ΔTNF-α、Δ注意缺陷分及Δ多动/冲动分呈负相关(P均<0.05)。结论:DHA能辅助盐酸哌甲酯治疗ADHD儿童,其原因可能与升高体内GDNF及降低炎症因子IL-6、TNF-α水平有关。Objective:To study the effects of docosahexaenoic acid(DHA)on clinical efficacy and the levels of serum glial-derived neurotrophic factor(GDNF)and inflammatory factors in children with attention-deficient hyperactivity disorder(ADHD).Method:118 children with ADHD were randomly divided into study group(n=60)and control group(n=58).The study group was given methylphenidate hydrochloride and 300 mg/d DHA capsules,and the control group was given methylphenidate hydrochloride and blank placebo capsules for 8 weeks.At baseline and after 8 weeks of treatment,the scores of the Chinese Version of the Swanson Nolan and Pelham,Version IV Scale-Parent Form(SNAP-IV)and Conner Behavior Assessment Scale for ADHD were used to assess the change of clinical symptoms.The adverse effects were also recorded.The levels of DHA,GDNF,interleukin 1β(IL-1β),IL-6 and tumor necrosis factorα(TNF-α)in the two groups were measured.Results:After 8 weeks of treatment,the SNAP-IV total score,attention deficit score and Conner scores for learning,psychosomatic and hyperactivity index had statistically significant differences between the two groups(P<0.05 or P<0.01).The levels of DHA and GDNF in the study group were significantly higher than those in the control group and at baseline,while the levels of IL-6 and TNF-αwere significantly lower than those in the control group and at baseline(P<0.05 or P<0.01).There was a negative correlation between the changes of DHA levels and SNAP-IV total score.The change of GDNF was negatively correlated with TNF-αlevels,attention deficit score,hyperactivity/impulsive score(all P<0.05).Conclusion:DHA is beneficial for the treatment of methylphenidate hydrochloride in children with ADHD,which may be related to the increase of GDNF level and the decrease of inflammatory factors IL-6 and TNF-αlevels.

关 键 词：注意缺陷多动障碍 二十二碳六烯酸 胶质源性神经营养因子 炎症因子 

分 类 号：R749.94[医药卫生—神经病学与精神病学]