注意缺陷多动障碍儿童危险因素的病例对照研究

Case-controlled Study on Risk Factors of Children with Attention Deficit Hyperactivity Disorder

目的探讨儿童注意缺陷多动障碍（attention deficit hyperactivity disorder,ADHD）的危险因素。方法采用自制的一般情况调查表对来自湖南省儿童医院儿童保健门诊就诊的204例6~12岁儿童ADHD和199例6~12岁的正常儿童进行单因素分析和非条件多因素Logistic回归分析,研究可能导致ADHD发病的危险因素。结果单因素分析：两组儿童的性格类型、家庭类型、父亲文化程度、母亲职业、家庭收入、母亲孕期情绪、分娩情况、儿童既往病史和家族相关病史等特征比较差异有统计学意义。多因素分析：以是否患ADHD为因变量,以儿童性格类型、父母文化程度、父母职业等因素为自变量的多元Logistic回归分析发现儿童外向性格（OR=7.12）、父母体罚孩子（OR=6.27）、父母溺爱（OR=5.94）、家庭收入低（OR=2.99）、父母严厉管教（OR=2.27）为儿童患ADHD的危险因素,儿童无既往病史（OR=0.08）、核心家庭（OR=0.38）、父亲文化程度高（OR=0.64）、无家族病史（OR=0.36）为儿童ADHD的保护因素。结论父母的教育方式、文化程度、家庭类型和家庭经济收入等因素在ADHD的发病中可能产生重要影响,因此,医务人员在ADHD的防治过程中应充分考虑这些危险因素的作用。

Objective To explore the risk factors of children with attention deficit hyperactivity disorder（ADHD）. Methods Self-made questionnaires were used to survey 204 ADHD children aged between 6 and 12 years and 199 normal children at the same age.The risk factors which resulted in the occurrence of ADHD were studied. Results Single factor analysis showed that the differences between the two groups were statistically significant in child＇s personality type,family type,father＇s educational level,mother＇s occupation,family income,mother＇s mood during pregnancy,delivery conditions,child＇s past disease history,family disease history,and so on.Unconditional multivariate Logistic regression analysis showed that child＇s outward personality（OR=7.12）,parental corporal punishment（OR=6.27）,parental overprotection（OR=5.94）,low family income（OR=2.99）, parental harsh discipline（OR=2.27） were the risk factors for children to suffer from ADHD,while children without past disease history（OR= 0.08）,nuclear family （OR=0.38）,father with high literacy（OR=0.64）,without family disease history （OR=0.36） were the protective factors. Conclusions There are many important factors in the etiology of ADHD,such as parents＇ education methods,parents＇ educational level,family type,family economy status and other factors.Therefore,medical professionals should fully consider these risk factors in the course of prevention and treatment of ADHD.