血清IL-10水平联合CARS及GDS量表评分在儿童孤独症谱系障碍诊断中的应用价值  

The Application Value of Serum Interleukin-10 Level Combined withCARS and GDS Scale Scores in the Diagnosis of AutismSpectrum Disorder in Children

作　　者：周苗 张传杰 ZHOU Miao;ZHANG Chuanjie(Pediatrics,Wuhan University of Science and Technology,Wuhan 430065,China;Wuhan Children’s Hospital(Wuhan Maternal and Child Healthcare Hospital),Tongji Medical College Huazhong University of Science&Technology,Wuhan 430061,China)

机构地区：[1]武汉科技大学医学部医学院,湖北武汉430065 [2]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院),湖北武汉430015

出　　处：《标记免疫分析与临床》2024年第11期2012-2018,共7页Labeled Immunoassays and Clinical Medicine

基　　金：武汉市卫生计生委科研项目(编号:WX19C11)。

摘　　要：目的探讨血清白细胞介素10(IL-10)水平、儿童孤独症评定量表(CARS)及Gesell发育诊断量表(GDS)评分在儿童孤独症谱系障碍(ASD)诊断中的应用价值。方法收集78例1~6岁疑似ASD患儿的临床资料和外周血,采用精神障碍诊断和统计手册(第5版)(DSM-5)将78例患儿分为ASD组和非ASD组,应用CARS量表评估患儿病情的严重程度,应用GDS量表评估患儿的发育水平。采用流式细胞术检测两组患儿血清IL-10水平,比较ASD组和非ASD组以及不同性别、年龄的ASD患儿血清IL-10水平、CARS量表评分、GDS量表5个子域评分及平均分的差异。应用Logistic回归分析血清IL-10水平、CARS量表评分及GDS量表平均分与ASD发病的相关性,通过受试者工作特征曲线(ROC)分析血清IL-10水平、CARS量表评分及GDS量表平均分单独及联合预测模型在ASD诊断中的应用价值。结果ASD组CARS量表评分显著高于非ASD组,血清IL-10水平、GDS量表的5个子域评分及平均分均显著低于非ASD组(P<0.05)。不同性别和年龄的ASD患儿血清IL-10水平未见明显差异(P>0.05)。女性ASD患儿CARS量表评分显著高于男性患儿(P<0.05),不同年龄的ASD患儿CARS量表评分未见明显差异(P>0.05)。女性ASD患儿GDS量表的适应性、语言、个人-社交板块评分及平均分显著低于男性ASD患儿(P<0.05),大运动和精细动作板块评分较男性患儿有降低趋势,但差异未达到统计学意义(P>0.05)。1~3岁ASD患儿GDS量表的大运动板块评分及平均分显著高于3~6岁ASD患儿,适应性、精细动作、语言和个人-社交板块评分与3~6岁ASD患儿相比未见明显差异(P>0.05)。1~6岁ASD患儿血清IL-10水平、CARS量表评分以及GDS量表平均分是ASD发病的独立风险因素。1~6岁ASD患儿血清IL-10水平、CARS量表评分及GDS量表平均分诊断ASD的AUC分别为0.64、0.91、0.85,3者联合诊断ASD的AUC为0.96,具有一定的诊断价值。结论1~6岁女性ASD患儿的病情更重,且女性Objective To investigate the application value of serum interleukin-10 level,Childhood Autism Rating Scale and Gesell Developmental Diagnostic Scale score in the diagnosis of childhood autism spectrum disorder.Methods The clinical data and peripheral blood samples of 80 children aged 1-6 years old with suspected autism were collected for the study.An autism group and non-ASD group were identified by following the Diagnostic and Statistical Manual of Mental Disorders(5th Edition).Childhood Autism Rating Scale was used to assess the severity of these children’s condition.Developmental levels of these children were evaluated by the Gesell Developmental Diagnostic Scale.Flow cytometry was used to detect the serum interleukin-10 level of the two groups,and the differences in the serum interleukin-10 level,the score of the Child Autism Rating Scale,and the five subdomains and average scores of the Gesell Developmental Diagnostic Scale were compared and evaluated between the autism group and the non-ASD group,as well as among children with autism of different genders and ages.Logistic regression was applied to analyze the correlation between serum interleukin-10,the average score of the Childhood Autism Rating Scale and the Gesell Developmental Diagnostic Scale and the incidence of ASD.The application values of serum interleukin-10,the score of the Childhood Autism Rating Scale and the average score of the Gesell Developmental Diagnostic Scale in the diagnosis of ASD were evaluated by the receiver operating characteristic curve.Results Scores of the Autism Rating Scale in the autism group were significantly higher than those in the non-ASD group,while the serum interleukin-10 level,the five subdomain scores and the average score of the Gesell Developmental Diagnostic Scale were significantly lower than those in the non-ASD group(P<0.05).There was no significant difference in serum interleukin-10 levels in children with autism of different genders and ages(P>0.05).The score of the Autism Rating Scale for female childre

关 键 词：孤独症谱系障碍 白细胞介素10 量表 诊断 应用价值 

分 类 号：R748[医药卫生—神经病学与精神病学]