摘要 目的：了解顺德龙江地区小学生抽动障碍（TD）的流行病学特征及其与微量元素的关系。方法：采用分层整群抽样方法，对顺德龙江地区4062名6~12岁的学龄儿童进行TD横断面调查，并检测TD患儿的血微量元素，同时取40例正常儿童作对照。结果：TD总患病率为2.98%；短暂性抽动障碍、慢性运动或发声抽动障碍、发声与多种运动联合抽动障碍的患病率分别为3.62%、2.39%、1.21%。男孩TD患病率显著高于女孩（3.92% vs 1.96%，P<0.05）。TD患儿血铜、锰、镁水平与正常儿童比较，差异无统计学意义（P>0.05），而血铅水平显著增高，血锌、铁水平则显著降低，差异均有统计学意义（P<0.05）。不同临床亚型的TD患儿的血微量元素差异无统计学意义（P>0.05）。结论：TD在6~12岁的学龄儿童中较多见，男孩患病率高于女孩；高血铅及锌、铁缺乏可能是TD的病因之一，治疗时应予以考虑。
Abstract：OBCTIVE: To investigate the epidemiological characteristics of tic disorders (TD) among pupils in the Shunde Longjiang area, and their relationship to trace elements. METHODS: A cross-sectional study of 4062 children aged 6-12 years, who were selected from the Shunde Longjiang area by stratified cluster sampling to investigate the epidemiological characteristics of TD, was conducted, and blood concentrations of trace elements in children with TD were determined. Forty normal children were selected as controls. RESULTS: The overall prevalence rate of TD was 2.98%; the prevalence rates of transient tic disorder, chronic motor or vocal tic disorder and Tourette's syndrome were 3.62%, 2.39% and 1.21% respectively. Boys had a significantly higher prevalence rate of TD than girls (3.92% vs 1.96%; P<0.05). There were no significant differences in blood copper, manganese and magnesium levels between children with TD and normal children (P>0.05), however, children with TD had a significantly increased blood lead level and significantly decreased blood zinc and iron levels compared with the normal children (P<0.05). No significant differences in trace elements were found between children with different subtypes of TD (P>0.05). CONCLUSIONS: TD is common in children aged 6-12 years and more prevalent in boys than in girls. High blood lead level and zinc and iron deficiencies may be one of the causes of TD, and thus should be considered during therapy.
LIU Ling,JIANG Zhi-Gui,LI Wei et al. Epidemiological investigation of tic disorders among pupils in the Shunde Longjiang area, and their relationship to trace elements[J]. CJCP, 2013, 15(8): 657-660.
Leckman JF, Riddle MA, Hardin MT, Ort SI, Swartz KL, Stevenson J, et al. The Yale Global Tic Severity Scale: initial testing of a clinician-rated scale of tic severity [J]. J Am Acad Child Adolesc Psychiatry, 1989, 28(4): 566-573.
[9]
Kenney C, Kuo SH, Jimenez-Shahed J. Tourette's syndrome [J] . Am Fam Physician, 2008, 77(5): 651-658．
Heresco LV, Javitt DC. Comparative effects of glycine and D-cycloserine on persistent negative symptoms in schizophrenia: a retrospective analysis[J]. Schizophr Res, 2004, 66(2-3): 89-96.
[14]
Anna R, Baviera G, Corrado F, Ientile R, Granese D, Stella NC. Plasma homocysteine in early and late pregnancies complicated with preeclampsia and isolated intrauterine growth restriction [J]. Acta Obstet Cynecol Scand, 2004, 83(2): 155-158.
