我国小学男生注意缺陷/多动障碍与入学年龄的相关性

Relationship between attention deficit and hyperactivity disorder(ADHD) and age at school entry among male primary school boys in 8 provinces in China

目的探索中国男性小学生注意缺陷/多动障碍（ADHD）与入学年龄的相关性,为探讨ADHD的影响因素并提出防控建议提供参考。方法选择中国疾病预防控制中心青年基金＂我国学龄儿童主要慢性病干预模式及适宜技术研究＂中的男性小学生12 731名作为研究对象,采用长处和困难问卷（SDQ）（家长版）的注意缺陷与多动量表分析提前入学和适龄入学男童在ADHD问题上的差异。结果提前入学男童比适龄入学男童ADHD得分更高（t=-2.373,P=0.018）,进一步将该量表分为多动、冲动和注意缺陷因子,发现提前入学男童的注意缺陷得分高于适龄入学男童（t=-2.610,P=0.009）,多动和冲动未发现统计学差异。提前入学男童在五、六年级时ADHD得分高于适龄入学者,一~四年级ADHD各因子分差异均无统计学意义（P值均〉0.05）。结论男童提前入学可能是ADHD的危险因素。应严格限制入学年龄,并对提前入学的儿童给予更多关注,减少ADHD症状的发生。

Objective To explore the relationship between Attention Deficit and Hyperactivity Disorder（ADHD） and age at school entry among 12 371 male primary school students in 8 provinces,and provide advices for ADHD prevention and control.Methods All respondents were male primary school students from the research project ＇Intervention Model for Chronic Diseases among School Children in China＇ funded by China CDC.The ADHD scale of Strengths and Difficulties Questionnaire（SDQ）（Parent Version） was adopted to quantify the difference of attention or activity problems between male students with early starting age and school-age male students.Results The ADHD score of early entry students were significantly higher than those who entered school until 6-year-old（t =-2.373,P = 0.018）,which occurred among students in grade five and grade six.After ADHD was divided into three factors,hyperactivity,impulsivity and attention deficit,there was no statistical difference between early and normal entry students on factors of hyperactivity and impulsivity,but the attention deficit score of early entry students was significantly higher（t =-2.610,P = 0.009） than that of normal entry ones.Conclusion Early school entry might be a risk factor of ADHD among male children.Age at school entry should be limited.Male students who entered school before 6-year-old should be given more attention to ADHD-type symptoms as well as quasi-autistic symptoms.