哈尔滨六年级学生忽视经历与自主神经症状失调的关联

Association between childhood neglect and the autonomic nerves disorder in students of sixth graders

目的了解哈尔滨市六年级学生的童年期忽视与自主神经功能现状及其关系,为改善儿童青少年身心健康状况提供指导意见。方法采用整群抽样方法,在哈尔滨市的2个区抽取5所学校1 259名在校六年级学生进行儿童创伤问卷(Childhood Trauma Questionnaire-Short Form,CTQ-SF)和自主神经症状调查表(TOHO University Medical Index,TMI)的调查。结果学生忽视总发生率为45.7%,其中情感忽视为18.8%,躯体忽视为40.8%。自主神经症状失调的检出率为47.2%。遭受过忽视及各维度的青少年自主神经症状失调检出率高于未遭受的青少年(χ2值分别为50.52,32.02,43.61,P值均<0.01),且随着忽视程度的增加,自主神经症状失调的检出也逐渐增加(χ2趋势值分别为47.99,47.07,49.24,P值均<0.01)。在控制性别的基础上,忽视及各维度均与自主神经症状失调呈正向关联(OR=1.53~2.34,P值均<0.05),忽视程度为轻中度、中重度、极重度的自主神经症状失调分别是忽视程度为"无/最小"的1.37,1.83,5.10倍(P值均<0.05)。结论哈尔滨市六年级学生童年期忽视经历与自主神经症状失调密切相关,且童年期忽视程度越严重,个体发生自主神经症状失调的检出概率越高。需要关注儿童忽视问题,及早评估自主神经功能状态。

Objective To explore prevalence of childhood neglect and autonomic nervous function,and its association in sixth graders students in Harbin,and to provide clues to improve physical and mental health of children and adolescents. Methods Cluster sampling method was used to select 1 259 students from grade 6 in 5 schools in two districts of Harbin,and Childhood Trauma Questionnaire-Short Form( CTQ-SF) and TOHO University Medical Index( TMI) were filled in. Results The total rate of childhood neglect was 45.7%,of which the rate of emotional neglect and physical neglect were 18.8%,40.8%. The rate of autonomic nerves disorder was 47.2%. The rate of autonomic nerves disorder in students suffered from neglect,emotional neglect,physical neglect are higher than those without any of neglect( χ2= 50.52,32.02,43.61,P<0.01),and with the increase of the degree of neglect,the rate of autonomic nervous disorder were gradually increasing( χ2= 47.99,47.07,49.24,P<0.01). After controlled for gender,neglect,emotional neglect,physical neglect were positively associated with autonomic nerves disorder( OR = 1.53-2.34,P<0.05),and the odd ratio for autonomic nerves disorder among those with mild-to-moderate,moderate-to-severe and extremely servere neglect was 1.37,1.83,5.10 compared to those with none or mild neglect. Conclusion Childhood neglect is closely related to adolescent the autonomic nerves disorder in sixth graders students in Harbin. Moreover,the more serious the childhood neglect is,the higher the detection rate of autonomic nerves disorder is. In order to improve the physical and mental health of children and adolescents,it is necessary to pay attention to childhood neglect and early assessment of their autonomic function.