莱阳市城乡4～16岁儿童抽动障碍现状调查

Tic disorder in children aged 4-16 years in Laiyang:a cross-sectional study

目的调查莱阳市城乡（城区、农村）4~16岁儿童抽动障碍（tic disorders,TD）的流行病学特征、家庭环境以及伴发的行为问题,为TD的科学干预创造条件。方法 2010年4—10月采用分层整群随机抽样的方法,从莱阳市城区和农村68 396名4~16岁儿童中抽取1 752名进行TD横断面调查。采用问卷调查和专科访谈相结合的方式,回收有效问卷1 588份。TD患儿作为TD组,相应条件的无TD儿童作为对照组。结果 4~16岁儿童TD总患病率1.70%,短暂性抽动障碍（transient ticdisorders,TTD）患病率0.94%、慢性抽动障碍（chronic tic disorders,CTD）患病率0.57%、多发性抽动症（tourette syndrome,TS）患病率0.19%。男生患病率2.43%,女生患病率0.99%,差异有统计学意义（P〈0.05）。平均发病年龄为（7.52±2.73）岁。TD组患儿家庭环境中的亲密度、知识性、道德宗教观评分与对照组比较差异有统计学意义（P〈0.05）。6~11岁TD组男性患儿抑郁、交往不良、强迫性、社交退缩、多动、攻击性、违纪评分以及总分高于同年龄、同性别对照组,差异均有统计学意义（均P〈0.05）;6~11岁TD组女性患儿抑郁、社交退缩、多动、攻击性评分以及总分高于同年龄、同性别对照组,差异均有统计学意义（均P〈0.05）。结论 TD在莱阳市城乡儿童中并不少见,男性患病率较女性高。TD患儿家庭环境较差,且伴有较多行为问题。

Objective To study the epidemiological features,family environment,and behavior problems in children with tic disorder（TD）,aged 4-16 years,in Laiyang.Methods Using stratified-cluster random sampling techniques,a crossed-sectional study was carried out in a total of 1 752 children who were selected from 68 396 children ranging in age from 4 to 16 years in Laiyang city and its countryside from April to October 2010.By a combination of questionnaire and follow-up examination,a total of 1 588 valid questionnaires were obtained.Results The prevalence rate of TD in children aged 4 to 6 years was 1.70%,with 2.43% in boys and 0.99% in girls.The prevalence rate of transient tic disorders（TTD）,chronic tic disorders（CTD）and Tourette syndrome（TS）was 0.94%,0.57% and 0.19% respectively.The prevalence rate was 2.43% in boys and 0.99% in girls,which showed significant difference between them（P0.05）.The average age of onset in TD was（7.52±2.73）years.Children with TD scored lower in family cohesion,intellectual-cultural orientation and religious emphasis than the control group（P0.05）.With Achenbach children＇s behavior checklist,boys with TD aged 6~11 years scored higher in depression,poor communication,compulsivity,social withdrawal,hyperactivity,aggressiveness,offensive behavior and the total score than the controls（P0.05）.Girls with TD had higher scores in depression,social withdrawal,hyperactivity,aggressiveness and total score than the controls（P0.05）.Conclusion TD is not rare in children who live in the urban and rural area of Laiyang.Boys usually have a higher incidence than girls.Children with tic disorder usually live in a worse family environment and are accompanied by more behavior problems.