注意缺陷多动障碍患儿血清ACE2,TWEAK和CCL5水平检测及诊断价值研究  

Detection and Diagnostic Value of Serum ACE2,TWEAK and CCL5 Levels in Children with Attention Deficit Hyperactivity Disorder

作　　者：王立宁[1] 史亚楠[2] 李宝广[3] WANG Lining;SHI Ya’nan;LI Baoguang(Department of Functional Testing,Hebei Maternal and Child Health Center,Shijiazhuang 050031,China;Department of Children’s Health,Hebei Maternal and Child Health Center,Shijiazhuang 050031,China;DepartmentⅡof Neurology,Hebei Children’s Hospital,Shijiazhuang 050031,China)

机构地区：[1]河北省妇幼保健中心功能检验科,石家庄050031 [2]河北省妇幼保健中心儿童保健科,石家庄050031 [3]河北省儿童医院神经内二科,石家庄050031

出　　处：《现代检验医学杂志》2024年第5期152-156,167,共6页Journal of Modern Laboratory Medicine

基　　金：河北省2024年度医学科学研究课题计划(编号:20240752)。

摘　　要：目的 探究血清血管紧张素转换酶2(angiotensin-converting enzyme 2,ACE2),细胞因子肿瘤坏死因子样细胞凋亡弱诱导因子(tumor necrosis factor-like weak inducer of apoptosis,TWEAK)和CC趋化因子配体5(CC motif chemokine ligand 5,CCL5)水平在注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)患儿诊断、病情严重程度评估中的价值。方法 选取2022年10月~2023年10月在河北省儿童医院就诊的125例ADHD患儿记为ADHD组,另选105例在河北省妇幼保健中心体检的健康儿童为对照组,根据临床总体印象严重程度量表(CGI-S)将患儿分为轻中度组(n=83)和重度组(n=42)。ELISA方法检测血清ACE2,TWEAK,CCL5,促黄体生成素(LH)和催乳素(PRL)水平,联合型瑞文测验(CRT)和Conners父母症状问卷(PSQ)对患儿认知和行为状况进行评分。Spearman相关性分析重度组血清ACE2,TWEAK,CCL5与CGI-S,CRT,PSQ评分的相关性;受试者工作特征(ROC)曲线分析ACE2,TWEAK,CCL5对ADHD及严重程度的诊断价值。结果 ADHD患儿血清ACE2(284.35±92.34 pg/ml),TWEAK(2.56±0.76 pg/ml)水平低于对照组(379.23±106.28 pg/ml,3.52±1.12 pg/ml),CCL5水平(7.36±2.37ng/ml)高于对照组(5.24±1.63 ng/ml),差异具有统计学意义(t=7.244,7.703,7.753,均P<0.05);重度组患儿CRT,血清ACE2,TWEAK水平低于轻中度组(t=5.318,6.686,6.490),而PSQ,CCL5水平较高于轻中度组(t=5.220,6.134),差异具有统计学意义(均P<0.05);Spearman相关性分析结果显示,重度组患儿血清ACE2,TWEAK水平与CGI-S,PSQ评分负相关(r=-0.432,-0.453;-0.421,-0.426,均P<0.001),与CRT评分呈正相关(r=0.427,0.418,均P<0.001);CCL5与CGI-S,PSQ评分呈正相关(r=0.421,0.433,均P<0.001),与CRT评分呈负相关(r=-0.446,P<0.001)。血清ACE2,TWEAK和CCL5诊断ADHD发生的AUC分别为0.814,0.803和0.807,三者联合诊断的AUC为0.945,优于各自单独诊断(Z=5.439,4.258,5.576,均P<0.001);血清ACE2,TWEAK,CCL5诊断重度ADHD的AUC分别为0.853,0.796和0.805,三者联合诊断的AUC为0.930,优于�Objective To investigate the value of serum angiotensin-converting enzyme 2(ACE2),tumor necrosis factor-like weak inducer of apoptosis(TWEAK)and CC motif chemokine ligand 5(CCL5)levels in the diagnosis and severity assessment of attention deficit hyperactivity disorder(ADHD)in children.Methods From October 2022 to October 2023,125 children with ADHD in Hebei Children’s Hospital were selected as ADHD group,and 105 healthy children in Hebei Maternal and Child Health Center were selected as control group.According to the Clinical Global Impressions-Severity(CGI-S),the children were separated into a mild to moderate group(n=83)and a severe group(n=42).ELISA was applied to detect levels of ACE2,TWEAK,CCL5,luteinizing hormone(LH),and prolactin(PRL).The combined raven test(CRT)and conners parental symptom questionnaire(PSQ)were applied to score the cognitive and behavioral status of children with disabilities.Spearman correlation was used to analyze the correlation among serum ACE2,TWEAK,and CCL5 with CGI-S,CRT,and PSQ scores in the severe group.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of ACE2,TWEAK,and CCL5 for ADHD and severity.Results The serum ACE2(284.35±92.34 pg/ml)and TWEAK(2.56±0.76 pg/ml)levels in children with ADHD were lower than those in the control group(379.23±106.28 pg/ml,3.52±1.12 pg/ml),while CCL5(7.36±2.37 ng/ml)level was higher than that in the control group(5.24±1.63 ng/ml),and the differences were statistically significant(t=7.244,7.703,7.753,all P<0.05).The levels of CRT,serum ACE2 and TWEAK in the severe group were lower than those in the mild to moderate group(t=5.318,6.686,6.490),while the levels of PSQ and CCL5 were higher than those in the mild to moderate group(t=5.220,6.134),and the differences were statistically significant(all P<0.05).Spearman correlation analysis results showed that the serum ACE2 and TWEAK levels in the severe group were negatively correlated with CGI-S and PSQ scores(r=-0.432,-0.453;-0.421,-0.426,all P<0.001),but po

关 键 词：注意缺陷多动障碍 血管紧张素转换酶2 细胞因子肿瘤坏死因子样细胞凋亡弱诱导因子 CC趋化因子配体5 

分 类 号：R749.94[医药卫生—神经病学与精神病学] R392.11[医药卫生—临床医学]