不同类型儿童注意缺陷多动障碍临床特点分析

Clinical characteristics of different subtypes of attention deficit hyperactivity disorders in children

目的研究不同类型注意缺陷多动障碍(ADHD)的临床特点以及共患病和功能损害的发生状况。方法将2013年1月至2014年7月期间在苏州大学附属儿童医院儿童保健科门诊确诊的1 534例ADHD患儿作为研究对象,分为注意缺陷型(ADHD-I)组、多动-冲动型(ADHD-HI)组和混合型(ADHD-C)组,由父母填写Vanderbilt ADHD父母评定量表,专科医师评估,并收集患儿的一般情况,对各类型ADHD患儿一般情况以及共患病和功能损害进行比较。结果 1 534例ADHD患儿男女比例为5.3:1。ADHD-I组女童的比例相对较另两个组为高(ADHD-I组与ADHD-HI组相比:χ2=6.00;ADHD-I组与ADHD-C组相比:χ2=16.21;均P<0.05)。ADHD-I组年龄为8.68±1.36岁,ADHD-HI组年龄为8.12±1.19岁,ADHD-C组年龄为8.35±1.25岁,3组之间年龄存在显著性差异(F=17.58,P<0.05)。共患病的发生率ADHD-I组为37.6%,ADHD-HI组为45.4%,ADHD-C组为56.2%,3组间差异有统计学意义(χ2=47.27,P<0.05),ADHD-C组最高。3组功能损害的发生率差异有统计学意义(χ2=47.86,P<0.05),ADHD-HI组最低。结论 ADHD以男孩为多,ADHD-C型共患病略高,ADHD-HI型功能损害较低。

Objective To investigate the characteristics, comorbidity and fimctional impairment of different subtypes of attention deficit hyperactivity disorders （ADHD）. Methods From January 2013 to July 2014 totally 1 534 children were diagnosed with ADHD in department of child health care in Children＇ s Hospital of Soochow University. They were included in this study and divided into ADHD-I group, ADHD-HI group and ADHD-C group. All the children＇ s guardians were asked to complete Vanderbih ADHD Parent Rating Scale （VADPRS） questiunnaires of ADHD which evaluated by physicians, and gender and age data of these children were also collected. Then children with difterent subtypes of ADHD were compared in terms of general information, comorbidity and functional impairments. Results The ratio of boy to girls in ADHD children was 5.3 ： 1. The percentage of gMs in ADHD-I group was higher than that in the other two groups （X2 value was 6.00 and 16.21, respectively, both P 〈 0.05）. The average age was 8.68±1.36 in ADHD-I group, 8.12± 1.19 in ADHD-HI group and 8.35 ＋ 1.25 in ADHD-C group, respectively, and there was significant difference among three groups （F = 17.58, P 〈0.05）. The incidence of comorbidity was 37.6%, 45.4% and 56.2% in ADHD-I group, ADHD-HI group and ADHD-C group, respectively, and the difference was statistically significant （X2 = 47. 27, P 〈 0.05 ）. There was significant difference in incidence of functional impairment among three groups （X2 = 47.86, P 〈 0.05 ） , and the incidence in ADHD-HI group was lowest. Conclusion There is a higher prevalence of ADHD in boys. The prevalence of comorbidity in children with ADHD-C is relatively high, while the functional impairment is lower in the children with ADHD-HI.