标题：注意缺陷多动障碍儿童外周血NOS1、NO表达水平及临床意义

      作者：王菊红 1，黎鹏 2    1.宝鸡市妇幼保健院儿童免疫内分泌科，陕西 宝鸡 721000；2.宝鸡市中医医院儿科，陕西 宝鸡 721000

      卷次： 2023年34卷8期

      【摘要】 目的 探究注意缺陷多动障碍(ADHD)患儿外周血一氧化氮合酶1 (NOS1)、一氧化氮(NO)的表达水平及临床意义。方法 选取2019年4月至2021年4月宝鸡市妇幼保健院和宝鸡市中医医院收治的93例ADHD患儿为研究组，并根据临床反应情况将其分为注意力缺陷为主型(PIT) 34例(PIT组)、多动-冲动为主型(HIT) 19例(HIT组)和混合型(CT) 40例(CT组)，另选取同期健康体检儿童122例作为对照组。收集所有受试儿童的一般资料，酶联免疫吸附法(ELISA)检测外周血NOS1、NO水平；采用Pearson相关性分析ADHD患儿外周血NOS1与NO的相关性；多因素Logistic回归分析ADHD发生的影响因素。结果 研究组患儿的胎儿宫内窘迫、产程延长、儿童孤独、父母经常吵架比例明显高于对照组，差异均有统计学意义(P<0.05)；研究组患儿的外周血NOS1、NO水平分别为(40.23±6.54) μmol/L、(44.51±13.43) U/mL，明显高于对照组的(25.34±5.82) μmol/L、(32.87±10.34) U/mL，差异均有统计学意义(P<0.05)；CT组患儿的外周血NOS1、NO水平分别为(44.19±7.03) μmol/L、(49.84±12.39) U/mL，HIT组患儿分别为(36.42±6.52) μmol/L、(42.31±12.04) U/mL，明显高于PIT组的(30.23±6.12) μmol/L、(35.48±10.96) U/mL，CT组患儿的外周血NOS1、NO水平又明显高于HIT组，差异均有统计学意义(P<0.05)；经Pearson相关性分析结果显示，ADHD患儿外周血NOS1水平与NO水平呈正相关(r=0.399，P<0.05)；经多因素Logistic回归分析结果显示，胎儿宫内窘迫、产程延长、儿童孤独、父母经常吵架、NOS1、NO是影响ADHD发生的危险因素(P<0.05)。结论 ADHD患儿外周血NOS1、NO水平上调，两者均可能在ADHD发生发展过程中发挥作用，检测外周血NOS1、NO水平有利于临床预测发生ADHD的可能性。
      【关键词】 注意缺陷多动障碍；一氧化氮合酶1；一氧化氮；临床意义；影响因素
      【中图分类号】 R729 【文献标识码】 A 【文章编号】 1003—6350（2023）08—1144—05

Expression levels of NOS1 and NO in peripheral blood of children with attention deficit hyperactivity disorderand their clinical significance.
WANG Ju-hong 1, LI Peng 2. 1. Department of Immunoendocrinology for Children, BaojiMaternal and Child Health Hospital, Baoji 721000, Shaanxi, CHINA; 2. Department of Paediatrics, Baoji Hospital ofTraditional Chinese Medicine, Baoji 721000, Shaanxi, CHINA
【Abstract】 Objective To explore the expression levels and clinical significance of nitric oxide synthase 1(NOS1) and nitric oxide (NO) in peripheral blood of children with attention deficit hyperactivity disorder (ADHD).Methods A total of 93 children with ADHD treated in Baoji Maternal and Child Health Hospital and Baoji Hospital ofTraditional Chinese Medicine from April 2019 to April 2021 were selected as the study group. According to the clinicalresponse, they were divided into 34 cases of predominantly inattentive type (PIT group), 19 cases of hyperactive-impul-sive type (HIT group), and 40 cases of commixture type (CT group). In addition, 122 children undergoing physical exam-ination during the same period were selected as the control group. The general information of all children were collected.Enzyme-linked immunosorbent assay (ELISA) method was used to detect the levels of NOS1 and NO in peripheralblood. Pearson correlation was used to analyze the correlation between NOS1 and NO in the peripheral blood of childrenwith ADHD. Multivariate Logistic regression was used to analyze the influencing factors of ADHD. Results The pro-portion of fetal distress, prolonged labor, children’s loneliness, and frequent parental quarrels in the study group weresignificantly higher than those in the control group (P<0.05). The levels of NOS1 and NO in peripheral blood of childrenin the study group were (40.23±6.54) μmol/L and (44.51±13.43) U/mL, respectively, which were significantly higher than(25.34±5.82) μmol/L and (32.87±10.34) U/mL in the control group (P<0.05). The levels of NOS1 and NO in peripheralblood of children were (44.19±7.03) μmol/L and (49.84±12.39) U/mL in CT group, respectively, (36.42±6.52) μmol/L and(42.31±12.04) U/mL in HIT group, which were significantly higher than (30.23±6.12) μmol/L and (35.48±10.96) U/mLin PIT group; the levels of NOS1 and NO in CT group were significantly higher than those in HIT group; the differenceswere statistically significant (P<0.05). Pearson correlation analysis showed that the level of NOS1 in peripheral blood ofADHD children was positively correlated with the level of NO (r=0.399, P<0.05). Multivariate logistic regression analy-sis showed that the fetal distress, prolonged labor, children’s loneliness, frequent parental quarrels, NOS1, and NO werethe risk factors of ADHD (P<0.05). Conclusion The levels of NOS1 and NO in the peripheral blood of children withADHD are up-regulated. Both of them may play a role in the occurrence and development of ADHD. The detection ofthe levels of NOS1 and NO in the peripheral blood is helpful for clinical prediction of the possibility of ADHD.
      【Key words】 Attention deficit hyperactivity disorder; Nitric oxide synthase 1; Nitric oxide; Clinical significance;Influence factor