先兆冲动与Tourette综合征患儿抽动症状严重程度关系研究

The Correlation between Premonitory Urges and Tic Symptoms Severity in TS Children

摘要: 目的：探究先兆冲动与Tourette综合征(Tourette syndrome, TS)患儿抽动症状严重程度相关性，为抽动障碍的临床诊断及心理干预提供新的理论依据。方法：按照年龄将105例TS患儿进行分组，小年龄组患儿(年龄在8~10岁)62名，大年龄组患儿(年龄 ≥ 11岁)43名，采用先兆冲动量表(PUTS)和耶鲁综合抽动严重程度量表(YGTSS)对患儿进行评价，对比不同年龄组患儿的PUTS、YGTSS评分差异，同时研究先兆冲动、年龄是否是抽动严重程度的影响因素。结果：两组患儿的PUTS、YGTSS评分差异均有统计学意义,小年龄组PUTS得分显著低于大年龄组患儿(15.35 ± 4.72 vs. 17.81 ± 6.53, P < 0.05)，YGTSS评分小年龄组得分显著低于大年龄组患儿(31.76 ± 13.11 vs. 35.37 ± 12.55, P < 0.05)；对患儿进行整体分析，Pearson相关分析结果显示PUTS得分与YGTSS总分及各子量表均显著相关(r为0.266~0.542，P < 0.05)。小年龄组PUTS得分与YGTSS总分、抽动频率、强度、复杂性、干扰及损害程度呈正相关(r为0.260~0.562，P < 0.05)，大年龄组PUTS得分与YGTSS总分、抽动次数、频率、强度及损害程度呈正相关(r为0.314~0.513，P < 0.05)；多元回归分析显示，先兆冲动可以显著影响抽动症状严重程度(β = 1.271, P < 0.05)，而年龄不是抽动症状严重程度的影响因素(β = −0.375, P > 0.05)。结论：先兆冲动与年龄有关；先兆冲动能够作为预测TS患儿抽动严重程度的影响因素。

Abstract: Objective: To explore the correlation between premonitory urges and severity of tic symptoms in children with Tourette syndrome (TS), and to provide a new theoretical basis for clinical diagnosis and psychological intervention of tic disorder. Methods: A total of 105 TS children were divided into four groups according to age, including 62 in the younger age group (8~10 years old) and 43 in the older age group (≥11 years old). All the children were evaluated with the Onset Impulse Scale (PUTS) and Yale Comprehensive Tic Severity Scale (YGTSS). Compared the difference of PUTS and YGTSS scores in different age groups, and investigated whether premonitory urges and age were relevant factors of tic severity. Results: The PUTS and YGTSS scores of the two groups were significantly different. The PUTS score of the younger age group was significantly lower than that of the older age group (15.35 ± 4.72 vs. 17.81 ± 6.53, P < 0.05), and the YGTSS score was the same (31.76 ± 13.11 vs. 35.37 ± 12.55, P < 0.05). Overall analysis of the children showed that PUTS score was significantly correlated with YGTSS total score and all subscales (r was 0.266~0.542, P < 0.05). The younger age group PUTS score was positively correlated with YGTSS total score, tic frequency, intensity, complexity, disturbance and damage degree (r was 0.260~0.562, P < 0.05). The older age group PUTS score was positively correlated with YGTSS total score, tic number, frequency, intensity and damage degree (r was 0.314~0.513, P < 0.05). Multiple regression analysis showed that premonitory urges could significantly affect tic symptoms severity (β = 1.271, P < 0.05), while age was not a relevant factor of tic symptoms severity (β = −0.375, P > 0.05). Conclusion: Premonitory urges is related to age and can be used as an effective relevant factor to predict the severity of tic in TS children.