包头蒙古族儿童注意缺陷多动障碍及与头发中微量元素的关系

Relationship between attention deficit hyperactivity disorder and the various elements in hair among Mongolian children in Baotou

目的了解包头市蒙古族儿童注意缺陷多动障碍与毛发中不同元素的关系,为预防儿童注意缺陷多动障碍提供理论依据。方法于2014年3月至2015年3月分别选择包头市市区及旗县区具有代表性的3所纯蒙古族小学1 000名二至六年级在校学生为研究对象,首先采用Conners儿童行为问卷中的教师问卷(简化版)对被试进行注意缺陷多动障碍筛查,再采用美国精神病学协会制定的《精神障碍诊断和统计手册》修订版(DSM-Ⅳ)的诊断标准进行诊断,同时选取同校、同年级、同性别、相互间无血缘关系的儿童作为健康对照组。对不同组儿童毛发中铜、锌、锰、铅、镉、砷、汞、硒8种元素的含量进行实验室检测。结果 1 000名蒙古族儿童中,儿童注意缺陷多动障碍的发生人数共38例,发生率为3.8%,其中男生30例,发生率为3.0%;女生8例,发生率为0.8%,差异有统计学意义(χ2=8.631,P<0.05);二至六年级儿童注意缺陷多动障碍发生率分别为0.2%,0.3%,0.8%,1.3%,1.2%,差异有统计学意义(χ2=12.824,P<0.05)。儿童注意缺陷多动障碍组发样中铜、铅、镉、铜锌比值均高于健康组,锌元素含量低于健康组,差异均有统计学意义(t值分别为-2.814,-4.785,-3.627,-4.117,2.105,P值均<0.05)。结论包头市蒙古族儿童注意缺陷多动障碍男生发生率高于女生且主要集中在小学高年级,蒙古族注意缺陷多动障碍儿童毛发中元素含量异常。预防少数民族地区儿童注意缺陷多动障碍应关注平时的元素摄入。

Objective To explore possible relation between attention deficit hyperactivity disorder with multiple elements in hair among Mongolian students from Inner Mongolia. Methods A total of 1 000 students （460 boys and 540 girls） from three Mongolian primary schools were investigated. The Conners Child Behavior Checklist （ teacher report version） was used to assess attention deficit hyperactivity disorder （ADHD） according to Diagnostic and Statistical Manual of Mental Disorders Revised Edition （ DSM- Ⅳ）. Control healthy students were selected from the same grade, same sex. Hair copper, zinc, manganese, lead, cadmium, arsenic, mercury, selenium level was assessed. Results Prevalence of ADHD was 3.8%（ n = 38）, with 30 boys. Significant differences were found by grades （grade 2 to grade 6： 0.2%, 0.3%, 0.8%, 1.3%, 1.2%, x^2 = 12.824, P〈0.05）. Hair copper and lead in children with ADHD was higher than healthy group（t=-2.814, -4.785, P〈0.05）, hair cadmium and copper zinc ratio was found higher in ADHD students（t =-3.627, -4.117, P〈0.05）. Hair zinc was lower than the healthy group（ t = 2.105, P〈0.05）. Conclu- sion Attention deficit hyperactivity disorder is high among Mongolian boys and high grades in primary school. Hair copper, lead, cadmium and copper zinc ratio is higher among attention deficit hyperactivity disorder children.