注意缺陷多动障碍儿童共患抽动障碍临床特征及影响因素分析

周克英, 肖智辉, 陈言钊, 张朝霞, 刘智屏, 杨春何, 高美好

中国当代儿科杂志 ›› 2014, Vol. 16 ›› Issue (9) : 892-895.

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中国当代儿科杂志 ›› 2014, Vol. 16 ›› Issue (9) : 892-895. DOI: 10.7499/j.issn.1008-8830.2014.09.005
论著·临床研究

注意缺陷多动障碍儿童共患抽动障碍临床特征及影响因素分析

  • 周克英1, 肖智辉1, 陈言钊1, 张朝霞1, 刘智屏1, 杨春何1, 高美好2
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Clinical features and risk factors of co-morbid tic disorder in children with attention deficit hyperactivity disorder

  • ZHOU Ke-Ying1, XIAO Zhi-Hui1, CHEN Yan-Zhao1, ZHANG Zhao-Xia1, LIU Zhi-Ping1, YANG Chun-He1, GAO Mei-Hao2
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摘要

目的 分析注意缺陷多动障碍(ADHD)儿童共患抽动障碍(TD)的临床特征及影响因素。方法 观察 312 名 ADHD 儿童共患 TD 情况,分析 ADHD 共患 TD 类型、不同亚型 ADHD 患儿的 TD 共患率,并对 13 个 ADHD 儿童共患 TD 的可能影响因素进行了单因素及多因素 logistic 回归分析。结果 312 名 ADHD儿童共患 TD 42 例(13.5%),ADHD 混合型(ADHD-C)TD 的共患率为 24.1%,高于 ADHD 多动-冲动型(ADHD-HI,10.9%)和 ADHD 注意缺陷型(ADHD-I,8.8%)患儿(P<0.05)。共患 TD 类型为短暂性 TD 21例(50.0%),慢性运动或发声 TD 12 例(28.6%),Tourette 综合征(TS)9 例(21.4%)。单因素分析显示沉溺手机或电脑游戏、不良饮食习惯、合并感染、家庭教育方式不当、父母亲间关系差、同学之间关系差等 6 个因素与 ADHD 共患 TD 有关。多因素 logistic 回归分析显示家庭教育方式不当、合并感染为 ADHD 共患 TD 的主要危险因素。结论 ADHD 共患 TD 受多种因素影响,应早期针对主要的危险因素进行干预。

Abstract

Objective To study the clinical features and risk factors of co-morbid tic disorder(TD) in children with attention deficit hyperactivity disorder(ADHD). Methods A total of 312 children with ADHD were involved in this study. Subtypes of co-morbid TD, incidences of TD in different subtypes of ADHD(ADHD-I, ADHD-HI and ADHD-C) were observed. Thirteen potential factors influencing the comorbidity rate of TD in ADHD were evaluated by univariate analysis and multiple logistic regression analysis. Results Forty-two of 312 children with ADHD suffered from co-morbid TD(13.5%). Comorbidity rate of TD in children with ADHD-C(24.1%) was significantly higher than in those with ADHD-HI(10.9%) and ADHD-I(8.8%)(P<0.05). There were 21 cases(50.0%) of transient TD, 12 cases(28.6%) of chronic TD, and 9 cases(21.4%) of Tourette syndrome. The univariate analysis revealed 6 factors associated with comorbidity: addiction to mobile phone or computer games, poor eating habits, infection, improper family education, poor relationship between parents and poor relationship with schoolmates. Multiple logistic analysis revealed two independent risk factors for comorbidity: improper family education(OR=7.000, P<0.05) and infection(OR=2.564,P<0.05). Conclusion The incidence of co-morbid TD in children with ADHD is influenced by many factors, and early interventions should be performed based on the main risk factors.

关键词

注意缺陷多动障碍 / 抽动障碍 / 临床特征 / 危险因素 / 儿童

Key words

Attention deficit hyperactivity disorder / Tic disorder / Clinical feature / Risk factor / Child

引用本文

导出引用
周克英, 肖智辉, 陈言钊, 张朝霞, 刘智屏, 杨春何, 高美好. 注意缺陷多动障碍儿童共患抽动障碍临床特征及影响因素分析[J]. 中国当代儿科杂志. 2014, 16(9): 892-895 https://doi.org/10.7499/j.issn.1008-8830.2014.09.005
ZHOU Ke-Ying, XIAO Zhi-Hui, CHEN Yan-Zhao, ZHANG Zhao-Xia, LIU Zhi-Ping, YANG Chun-He, GAO Mei-Hao. Clinical features and risk factors of co-morbid tic disorder in children with attention deficit hyperactivity disorder[J]. Chinese Journal of Contemporary Pediatrics. 2014, 16(9): 892-895 https://doi.org/10.7499/j.issn.1008-8830.2014.09.005

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基金

深圳市科技计划项目(200902015),深圳市知识创新计划项目(20140327234100)。

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