儿童注意缺陷多动障碍行为相关因素的调查

The research on the risk factors of behavioral correlation for ADHD

目的:探讨儿童注意缺陷多动障碍(ADHD)的行为相关危险因素,为有效地控制疾病的发生提供依据。方法:采用父母教养方式评价量表(EMBU)及自编问卷调查2005年11月～2008年11月儿童保健门诊的556名患儿及其家长,本研究为病例对照研究,按照年龄、性别进行1∶1配对。结果:病例组比对照组更多见的是父亲的惩罚严厉、拒绝否认和母亲的惩罚严厉,而父母的情感温暖、理解的分值较低;多因素条件Logistic回归分析发现儿童注意缺陷多动障碍的行为相关危险因素包括:父亲吸烟、母亲怀孕期间吸烟或酗酒、母乳喂养、父母亲文化程度、父母亲职业、父母离异、家庭环境不和谐(家庭亲密度低、情感表达少、矛盾多),其OR值及可信区间分别为2.200(1.474～3.283)、3.423(0.232～0.770)、2.174(1.340～3.527)、0.331(4.863～6.025)、0.450(0.294～0.690)、0.085(1.511～2.878)、2.598(2.134～5.698)和0.145(1.865～6.041)。结论:加强对儿童注意缺陷多动障碍行为相关危险因素的干预,对减少儿童注意缺陷多动障碍的发生有重要意义。

Objective： To explore the risk factors of behavioral correlation for ADHD, and to provide evidence for its effective prevention, intervention and control. Methods： A total of 278 cases with ADHD were selected from November 2005 to November 2008 and equally matched with control group without ADR-TB by age and gender. 556 children and their parents were assessed with EMBU and a self-compiled questionnaire. Results： The score of fathers＇ severe punishment, refusal, denial and mothers＇ punishment in the ADHD group were higher than that in the control group, meanwhile the score of parents＇ kindness, understanding in the ADHD group were lower than that in the control group. The main risk factors of behavioral correlation for ADHD were parents smoking during gestation period, mother drinking during gestation period, breast feeding, parents＂ educational level, occupation, parents dissociation and disharmony of home environment, the adjusted OR and CI respectively were 2.200（1.474-3.283）, 3.423（0.232-0.770）, 2.174（1.340-3.527）, 0.331（4.863-6.025）, 0.450（0.294-0.690）, 0.085（1.511-2.878）, 2.598（2.134-5.698） and 0.145（1.865-6.041）. Conclusion： The results of this study have implications for improving the prevention and control of ADHD.