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目的:观察阿立哌唑对儿童Tourette综合征患儿血清细胞因子水平的影响及疗效。方法:选取88例儿童Tourette综合征患儿,随机分为试验组和对照组。对照组患儿予以口服氟哌啶醇治疗,先给予1.0 mg/d,每周加量1次,至症状消失或达最大剂量6.0 mg/d。试验组予以口服阿立哌唑治疗,先给予2.5 mg/d,每周加量1次,至症状消失或达最大剂量10.0 mg/d。两组患儿均连用≥8周。观察两组患儿治疗前和治疗8周后血清IL-6、IL-8和TNF-α水平的变化,并采用YGTSS评分和不良反应量表(TESS)于治疗结束后评定疗效和不良反应。结果:试验组和对照组患儿治疗中分别失访3例和5例,两组失访率比较差异无统计学意义(χ2=0.50,P>0.05)。治疗8周后,两组患儿血清IL-6、IL-8水平较前明显上升,TNF-α水平较前明显下降(P<0.05),且试验组患儿变化幅度较对照组更大(P<0.05);同时试验组患儿临床总有效率92.68%,高于对照组的76.32%,(χ2=4.07,P<0.05)。采用TESS评分评定药物不良反应,试验组患儿不良反应发生率低于对照组(χ2=4.39,P<0.05)。结论:阿立哌唑治疗儿童Tourette综合征临床效果及安全性均明显优于氟哌啶醇,其作用机制可能与其能通过升高血清IL-6、IL-8和降低血清TNF-α水平,提高其免疫功能及抑制炎症反应密切相关。
Objective: To observe the effect of aripiprazole on the level of serum cytokines in children with Tourette syndrome and its therapeutic effect. Methods: 88 children with Tourette syndrome were randomly divided into experimental group and control group. Children in the control group were treated with haloperidol. Patients were initially given 1.0 mg / d once a week until the symptoms disappeared or the maximum dose was 6.0 mg / d. The experimental group was treated with aripiprazole orally. 2.5 mg / d was given first and once a week until symptoms disappeared or the maximum dose was 10.0 mg / d. Two groups of children were treated with ≥ 8 weeks. The changes of serum IL-6, IL-8 and TNF-α levels before and 8 weeks after treatment in both groups were observed. The efficacy and adverse reactions were evaluated after treatment by YGTSS score and adverse reaction scale (TESS). Results: The treatment group and the control group were lost to treatment in 3 cases and 5 cases, respectively. There was no significant difference in the follow-up rate between the two groups (χ2 = 0.50, P> 0.05). After 8 weeks of treatment, the levels of IL-6 and IL-8 in serum of the two groups increased significantly compared with those before (P <0.05), and the changes in the experimental group were more than those in the control group P <0.05). At the same time, the total clinical effective rate of the experimental group was 92.68%, which was 76.32% higher than that of the control group (χ2 = 4.07, P <0.05). The TESS score was used to assess adverse drug reactions. The incidence of adverse reactions in the experimental group was lower than that in the control group (χ2 = 4.39, P <0.05). Conclusion: Aripiprazole treatment of children with Tourette syndrome clinical efficacy and safety were significantly better than haloperidol, its mechanism may be related to its ability to raise serum IL-6, IL-8 and reduce the level of serum TNF-α, Improve their immune function and inhibit inflammation are closely related.