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注意缺陷多动障碍患儿智商的影响因素分析
  • 期刊名称:北京大学学报(医学版).41(3):285-290,2009年6月
  • 时间:0
  • 分类:R742.89[医药卫生—神经病学与精神病学;医药卫生—临床医学]
  • 作者机构:[1]北京大学精神卫生研究所儿童研究室,卫生部精神卫生学重点实验室,北京100191
  • 相关基金:基金项目:卫生行业科研专项经费资助项目(200802073)、国家自然科学基金项目(30770774)和“十一五”国家科技支撑计划资助项目 (2007BAI17B03) Supported by the Commonweal Sciences Foundation, Ministry of Health, China(200802073) , the National Natural Sciences Founda- tion of China(30770774) , and the National Foundation, Ministry of Seieneeand Technology, China(2007BAI17B03 )
  • 相关项目:注意缺陷多动障碍相关功能基因交互作用的研究
中文摘要:

目的:探讨5-羟色胺(5-HT)系统5-HT2A受体基因(HTR2A)-1438A/G、儿茶酚-O-甲基转移酶(COMT)基因Val158Met、单胺氧化酶A(MAOA)30 bp-VNTR多态及父母受教育程度等多因素对儿童注意缺陷多动障碍(ADHD)智商的影响。方法:对485例汉族ADHD患儿进行韦氏智商评定和HTR2A-1438A/G、COMT基因Val158Met和MAOA基因30 bp-VNTR多态性的检测,比较各基因型组间智商的差异,同时对影响智力的相关因素进行多元线性回归分析。结果:患儿经过C-WISC测试后,MAOA基因两组基因型FIQ上的差异趋于有统计学意义,低活性组(男3R,女3R3R)的得分高于高活性组(男4R,女3R4R/4R4R)[(102.6±12.4)vs(100.3±11.7),P=0.078] COMT基因两组基因型FIQ上的差异有统计学意义,高活性组(ValVal)的得分明显高于中低活性组(ValMet和MetMet)[(103.5±13.6)vs(100.5±11.5),P=0.036] HTR2A3组基因型FIQ和VIQ的差异有统计学意义 经两两比较,GG基因型组的得分分别明显高于GA和AA组[FIQ:(106.9±10.7)vs(100.7±12.3)vs(101.7±12.9),P=0.003 VIQ:(110.1±10.6)vs(103.5±12.1)vs(105.1±13.2),P=0.001] 父母的受教育程度与患儿的FIQ、VIQ及PIQ均相关。经多因素分析,保留在FIQ和VIQ模型中的自变量有2个:HTR2A基因型和母亲受教育程度 保留在PIQ模型中的自变量有1个,即HTR2A基因型。结论:提示5-HT系统的HTR2A基因-1438A/G多态以及母亲的受教育程度是中国汉族ADHD患儿智商的影响因素。

英文摘要:

Objective :To investigate the association of 5-HT2A receptor gene (HTR2A) -1438A/G, Cat- echol-O-methyltransferase (COMT) gene Val158Met, Monoamine oxidase A ( MAOA ) gene 30 bp-VN- TR(MAOA-uVNTR) polymorphisms, and the educational attainment level of the parents with the intelli- gence of attention deficit hyperactivity disorder (ADHD) in China. Methods: A total of 485 DSM-IV ADHD children of Chinese Han descent were included, both complete IQ evaluation, HTR2A-1438A/G, COMT gene Val158Met, and MAOA-uVNTR genotyping results were obtained. The quantitative traits of psychometric IQ were calculated by using the Chinese Wechsler Intelligence Scale for Children (C-WISC). The multifactor linear regression analysis was used to test the associated factors on intelligence. Results: Analyses revealed that ADHD children with low enzymatic activity (3R for males, 3R3R for females) of MAOA-uVNTR performed better on Full Scale IQ (FIQ) than did patients with high enzymatic activity (4R for males, 3R4R/4R4R for females) [ ( 102.6 ± 12. 4) vs ( 100. 3 ±11.7), P = 0. 0781. The patients with high-enzymatic activity (ValVal) of COMT gene Val158Met performed significantly bet- ter on FIQ than did patients with mid-low enzymatic activity (ValMet and MetMet) [ (103.5 ± 13.6) vs ( 100.5 ± 11.5) , P = 0. 036 ]. ADHD children with GG genotype of HTR2A-1438A/G performed signi- ficantly better on some aspects of C-WISC test (Full Scale IQ and Verbal Scale IQ) than did children with GA and AA genotypes[ FIQ : ( 106.9± 10. 7) vs ( 100.7 ± 12. 3) vs ( 101.7 ± 12.9), P =0. 003 ; VIQ: (110. 1±10.6) vs (103.5±12. 1) vs (105.1±13.2), P=O. OOl]. The educational attainment level of the parents was associated with all the aspects of C-WISC test (Full Scale IQ, Verbal Scale IQ, and Performance Scale IQ). The multiple linear regression analysis showed that the genotype of HTR2A- 1438A/G had significant correlation with FIQ, VIQ and PIQ; wh

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