注意缺陷多动障碍患儿血清胶质细胞源性神经营养因子和血管内皮生长因子C表达水平及诊断价值  

Expression levels and diagnostic value of GDNF and VEGF-C in serum of children with attention deficit and hyperactive disorder

作　　者：赫操 张丽娜[1] 吴哲[1] 巫江丽[1] 周国岭[1] HE Cao;ZHANG Li-Na;WU Zhe(The First Department of Psychiatry,the Seventh People’s Hospital of Hangzhou City,Hangzhou,Zhejiang 310000,China)

机构地区：[1]杭州市第七人民医院精神一科,浙江杭州310000

出　　处：《中国妇幼保健》2022年第1期54-57,共4页Maternal and Child Health Care of China

基　　金：浙江省医药卫生科技计划项目(2019KY517)。

摘　　要：目的分析注意缺陷多动障碍(ADHD)患儿血清胶质细胞源性神经营养因子(GDNF)和血管内皮生长因子C(VEGF-C)的表达水平,探讨其诊断价值。方法选择2017年5月—2019年5月杭州市第七人民医院收治的200例ADHD患儿为观察组,另选择同期体检的200例健康儿童为对照组。采用酶联免疫吸附法(ELISA)检测血清GDNF和VEGF-C水平,采用Pearson法分析ADHD患儿血清GDNF、VEGF-C表达水平与血清铁蛋白、血镁及多动指数的相关性,采用ROC曲线分析血清GDNF、VEGF-C水平对儿童ADHD的诊断价值。结果观察组血清铁蛋白、血镁水平及多动指数分别为(31.27±9.54)μg/L、(0.54±0.27)mmol/L及(1.87±0.24)分,对照组血清铁蛋白、血镁水平及多动指数分别为(60.62±10.85)μg/L、(0.91±0.36)mmol/L及(1.26±0.17)分,两组比较差异均有统计学意义(t=28.729,11.628,29.332,均P<0.05)。观察组血清GDNF和VEGF-C表达水平分别为(7.27±1.62)pg/ml和(35.62±8.17)ng/ml,对照组血清GDNF和VEGF-C表达水平分别为(9.45±2.15)pg/ml和(26.27±6.24)ng/ml,两组比较差异均有统计学意义(t=11.452,12.862,P<0.05)。ADHD患儿血清GDNF水平与血清铁蛋白、血镁水平均呈正相关(r=0.542、0.581,均P<0.05),与多动指数呈负相关(r=-0.600,P<0.05);血清VEGF-C水平与血清铁蛋白、血镁水平均呈负相关(r=-0.547、-0.586,均P<0.05),与多动指数呈正相关(r=0.592,P<0.05)。血清GDNF水平诊断ADHD的曲线下面积为0.767(95%CI:0.721~0.813,P=0.000),灵敏度为79.0%,特异度为62.5%。血清VEGF-C水平诊断ADHD的曲线下面积为0.824(95%CI:0.783~0.865,P=0.000),灵敏度为72.5%,特异度为80.0%。血清GDNF和VEGF-C水平联合诊断ADHD的曲线下面积为0.833(95%CI:0.792~0.873,P=0.000),灵敏度为72.5%,特异度为85.5%。结论ADHD患儿血清GDNF表达水平降低,VEGF-C表达水平升高,二者联合检测对儿童ADHD具有较高的诊断价值,临床检测儿童血清GDNF、VEGF-C表达水平对ADHD的早期诊断具有指导意义。Objective To analyze the expression levels of serum glial cell line-derived neurotrophic growth factor(GDNF)and vascular endothelial growth factor-C(VEGF-C)in children with attention deficit and hyperactive disorder(ADHD),explore the diagnostic value.Methods From May 2017 to May 2019,200 children with ADHD treated in the Seventh People’s Hospital of Hangzhou City were selected as observation group,200 healthy children receiving physical examination were selected as control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of serum GDNF and VEGF-C,Pearson method was used to analyze the correlations between expression levels of serum GDNF and VEGF-C and serum ferritin,magnesium,and hyperactivity index in ADHD children,ROC curve was used to analyze the diagnostic value of serum GDNF and VEGF-C levels in children with ADHD.Results The levels of serum ferritin,magnesium,and hyperactivity index in observation group were(31.27±9.54)μg/L,(0.54±0.27)mmol/L,and(1.87±0.24),respectively;the levels of serum ferritin,magnesium,and hyperactivity index in control group were(60.62±10.85)μg/L,(0.91±0.36)mmol/L,and(1.26±0.17),respectively,there were statistically significant differences between the two groups(t=28.729,11.628,29.332,P<0.05).The expression levels of serum GDNF and VEGF-C in observation group were(7.27±1.62)pg/ml and(35.62±8.17)ng/ml,respectively;the expression levels of serum GDNF and VEGF-C in control group were(9.45±2.15)pg/ml and(26.27±6.24)ng/ml,respectively,there were statistically significant differences between the two groups(t=11.452,12.862,P<0.05).In ADHD children,serum GDNF level was positively correlated with serum ferritin and magnesium and negatively correlated with hyperactivity index(r=0.542,0.581,-0.600,P<0.05);serum VEGF-C level was negatively correlated with serum ferritin and magnesium and positively correlated with hyperactivity index(r=-0.547,-0.586,0.592,P<0.05).The area under ROC curve,sensitivity,and specificity of serum GDNF in diagnosis of ADHD were 0.

关 键 词：注意缺陷多动障碍 胶质细胞源性神经营养因子 血管内皮生长因子C 诊断价值 

分 类 号：R729[医药卫生—儿科]