探讨孤独症谱系障碍(ASD)患儿血浆催产素和精氨酸后叶加压素(AVP)水平与ASD发病的关系。

选择2014年1月1日至2016年12月31日在首都儿科研究所就诊的40例ASD患儿为研究对象，年龄为2.0～12.0岁，并纳入ASD组。选择同期于同一医院进行体格检查的34例健康儿童纳入对照组，年龄为2.4～7.4岁。应用《儿童期孤独症评定量表》(CARS)和《精神疾病诊断与统计手册》第5版(DSM-5)对40例ASD患儿进行孤独症诊断及孤独症症状严重程度进行评定。采用酶联免疫吸附试验(ELISA)法定量检测2组受试儿血浆催产素和AVP水平。采用成组t检验，比较2组受试儿血浆催产素和AVP水平；采用直线相关性分析，对血浆催产素、血浆AVP水平与CARS评分的相关性进行分析。本研究遵循的程序符合首都儿科研究所人体试验委员会制定的伦理学标准，得到该委员会批准(审批号为[2012]-004)，均与所有受试儿的法定监护人签署临床研究知情同意书。

①2组受试儿的年龄、性别构成比比较，差异均无统计学意义(P>0.05)。② ASD组患儿血浆催产素水平为(359.2±103.3)pg/mL，显著低于对照组的(484.1±50.1)pg/mL，2组比较，差异有统计学意义(t＝－6.43，P<0.001)；ASD组患儿血浆AVP水平为(342.8±61.2)pg/mL，显著高于对照组的(312.2±39.2)pg/mL，2组比较，差异亦有统计学意义(t＝2.51，P＝0.014)。③相关性分析结果显示，ASD组患儿血浆催产素水平与CARS评分呈负相关关系(r＝－0.155，P＝0.032)，血浆AVP水平与CARS评分无相关关系(r＝0.032，P＝0.841)，血浆催产素水平与血浆AVP水平无相关关系(r＝0.191，P＝0.220)。对照组中，患儿血浆催产素水平与血浆AVP水平呈正相关关系(r＝0.631，P<0.001)。

ASD患儿血浆催产素水平降低，而血浆AVP水平升高，血浆催产素和AVP水平变化可能与ASD发病相关。

To investigate correlation between levels of plasma oxytocin, arginine vasopressin (AVP) and autism spectrum disorder (ASD) in children.

A total of 40 ASD children aged 2.0 to 12.0 years were admitted in the Capital Institute of Pediatrics from January 1, 2014 to December 31, 2016, and included in ASD group. Meanwhile, another 34 healthy children aged 2.4 to 7.4 years were selected as control group during the same period in the same hospital. Childhood Autism Rating Scale (CARS) and Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5) were used to evaluate the severity of autistic symptoms. The levels of plasma oxytocin and AVP were detected by enzyme-linked immunosorbent assay (ELISA). The levels of plasma oxytocin and AVP between two groups were compared by independent-samples t test. And the correlation between levels of plasma oxytocin, AVP and CARS scores were analyzed by linear correlation analysis. The study protocol was approved by the Ethnical Review Board of Investigation in Human Beings of Capital Institute of Pediatrics (approval number: [2012]-004). Informed consent was obtained from each participant′s guardians.

① There were no significant differences between two groups in age and constituent ratio of gender (P>0.05). ② The level of plasma oxytocin was (359.2±103.3) pg/mL in ASD group, which was significant lower than (484.1±50.1) pg/mL in control group, and the difference between two groups was statistically significant (t=-6.43, P<0.001). Besides, the level of plasma AVP was (342.8±61.2) pg/mL in ASD group, which was significant higher than (312.2±39.2) pg/mL in control group, and the difference between two groups was statistically significant (t=2.51, P=0.014). ③ In ASD group, there was a negative correlation between plasma oxytocin level and CARS score in children with ASD (r=-0.155, P=0.032), and plasma AVP level was not correlated with CARS score (r=0.032, P=0.841), plasma oxytocin level also was not associated with plasma AVP level (r=0.191, P=0.220). In control group, plasma oxytocin level was positively correlated with plasma AVP level (r=0.631, P<0.001).

Plasma oxytocin level decreases and plasma AVP level increases in children with ASD. The changes of plasma oxytocin and AVP may be involved in the pathogenesis of ASD.