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与暂时性抽动障碍患儿预后相关的因素:一项前瞻性队列研究。

Factors linked to prognosis in children with provisional tic disorder: a prospective cohort study.

机构信息

Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China.

Institute of Health Surveillance, Analysis and Protection, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, 430079, China.

出版信息

Eur J Pediatr. 2024 Sep;183(9):4009-4017. doi: 10.1007/s00431-024-05651-y. Epub 2024 Jul 1.

Abstract

The purpose of the present study was to estimate the factors linked to the prognosis of children with provisional tic disorder (PTD). We conducted a prospective cohort study enrolled children with PTD who were subsequently followed-up at three-month intervals for 1 year post-enrolment. A total of 259 PTD patients were included in the final analysis. At the end of the follow-up period, 77 (30%) of the patients had achieved clinical remission. Result of the LASSO logistic regression analysis revealed that a disease duration >3 months (OR=4.20, 95% CI 1.20-14.73), moderate/severe tic severity (OR=5.57, 95% CI 2.26-13.76), and comorbid behavioral problems (OR=2.78, 95% CI 1.15-6.69) were significant factors linked to remission in the PTD patients. The path analysis model showed that comorbid behavioral problems and recurrence partially mediated the association between tic severity and remission, with a mediating effect of 37%. Conclusions: We have identified several significant factors linked to prognosis in children with PTD, including comorbid behavioral problems and recurrence, which were found to be important mediators. These findings provide new insights for the clinical management of patients with PTD.

摘要

本研究旨在评估与暂时性抽动障碍(PTD)患儿预后相关的因素。我们进行了一项前瞻性队列研究,纳入了随后在入组后每 3 个月随访 1 年的 PTD 患儿。共有 259 例 PTD 患者纳入最终分析。随访结束时,77 例(30%)患者达到临床缓解。LASSO 逻辑回归分析结果显示,病程>3 个月(OR=4.20,95%CI 1.20-14.73)、中重度抽动严重程度(OR=5.57,95%CI 2.26-13.76)和共患行为问题(OR=2.78,95%CI 1.15-6.69)是 PTD 患者缓解的显著相关因素。路径分析模型显示,共患行为问题和复发部分中介了抽动严重程度与缓解之间的关系,中介效应为 37%。结论:我们已经确定了与 PTD 患儿预后相关的几个重要因素,包括共患行为问题和复发,它们被认为是重要的中介因素。这些发现为 PTD 患者的临床管理提供了新的见解。

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