儿童抽动障碍共患注意缺陷多动障碍的影响因素及其联合作用研究

doi:10.11852/zgetbjzz2025-0314

中国儿童保健杂志 ›› 2025, Vol. 33 ›› Issue (12): 1298-1302.DOI: 10.11852/zgetbjzz2025-0314

儿童抽动障碍共患注意缺陷多动障碍的影响因素及其联合作用研究

陈熔, 蔡莹莹, 李沁瑜, 陈亮亮, 刘秀梅

福建省儿童医院(上海儿童医学中心福建医院)发育行为儿科;福建医科大学妇儿临床医学院;福建省儿童神经发育性疾病临床医学研究中心,福建福州 350012

收稿日期:2025-03-28 修回日期:2025-09-08 发布日期:2025-12-02 出版日期:2025-12-10
通讯作者: 刘秀梅,E-mail:xmliu0615@fjmu.edu.cn
作者简介:陈熔(1991—),女,硕士学位,主要研究方向为儿童保健与发育行为。
基金资助:
福建省医学创新课题项目(2022CXB012);福建医科大学启航基金一般项目(2023QH1237)

Influencing factors and combined effects in children with tic disorder and comorbid attention-deficit/hyperactivity disorder

CHEN Rong, CAI Yingying, LI Qinyu, CHEN Liangliang, LIU Xiumei

Department of Developmental and Behavioral Pediatrics, Fujian Children′s Hospital(Fujian Branch of Shanghai Children′s Medical Center); College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University; Clinical Research Center for Pediatric Neurodevelopmental Disease of Fujian Province, Fuzhou, Fujian 350012, China

Received:2025-03-28 Revised:2025-09-08 Online:2025-12-10 Published:2025-12-02
Contact: LIU Xiumei,E-mail:xmliu0615@fjmu.edu.cn

摘要/Abstract

摘要： 目的探讨儿童抽动障碍(TD)共患注意缺陷多动障碍(ADHD)主要影响因素及其联合作用,为TD共患ADHD(TD+ADHD)防治策略的制定提供理论依据。方法纳入2023年1月—2024年4月在福建省儿童医院发育行为儿科门诊就诊的80例儿童TD+ADHD新发病例作为观察组,并将按观察组性别、年龄频数匹配的同期在该科室就诊的178例儿童单纯TD新发病例作为对照组,进行问卷调查。结果单因素分析结果显示,TD+ADHD组儿童与单纯TD组儿童在TD家族史(χ²=4.093)、父母有过敏性疾病(χ²=7.912)、体罚(χ²=10.393)、批评(χ²=19.457)、饲养宠物(χ²=5.142)方面,差异均有统计学意义(P<0.05)。多因素非条件logistic回归分析结果显示,父母有过敏性疾病且遭受体罚的TD儿童,其共患ADHD的风险为父母无过敏性疾病且无被体罚的TD儿童的4.485倍(95%CI:1.915～10.505,P<0.01);父母有过敏性疾病且饲养宠物的TD儿童,其共患ADHD的风险为父母无过敏性疾病且未饲养宠物的TD儿童的5.006倍(95%CI:1.815～13.807,P<0.01);父母有过敏性疾病且被体罚和饲养宠物的TD儿童,其共患ADHD风险为父母无过敏性疾病且无被体罚和未饲养宠物的TD儿童的18.693倍(95%CI:3.862~90.488,P<0.001)。结论儿童TD共患ADHD是遗传因素和环境因素综合作用的结果,父母有过敏性疾病联合体罚、饲养宠物会显著增加TD儿童共患ADHD的风险。

关键词: 抽动障碍, 注意缺陷多动障碍, 父母有过敏性疾病, 体罚, 饲养宠物

Abstract: Objective To explore the main influencing factors and their combined effects on tic disorder (TD) comorbid with attention-deficit/hyperactivity disorder(ADHD) in children, in order to provide a theoretical basis for developing prevention and treatment strategies for TD with ADHD (TD+ADHD). Methods A total of 80 new cases of TD+ADHD treated in the Department of Developmental and Behavioral Pediatrics of Fujian Children′s Hospital from January 2023 to April 2024 were included as the observation group, and 178 new cases of TD-only treated in the same department matched by gender and age frequency of the observation group were included as the control group. A questionnaire survey was administered. Results Univariate analysis showed that there were statistically significant differences in family history of TD (χ²=4.093), parental allergic disease (χ²=7.912), corporal punishment (χ²=10.393), criticism (χ²=19.457) and keeping pets (χ²=5.142) (P<0.05) between the TD+ADHD group and the TD-only group. Multivariate unconditional logistic regression analysis showed that the risk of ADHD comorbidity in TD children whose parents had allergic diseases and who experienced corporal punishment was 4.485 times that of TD children whose parents had no allergic diseases and who experienced no corporal punishment (95%CI: 1.915 - 10.505,P<0.01). The risk for TD children whose parents had allergic diseases and kept pets was 5.006 times that of those whose parents had no allergic diseases and did not keep pets (95%CI: 1.815 - 13.807,P<0.01). The risk for TD children whose parents had allergic diseases and who experienced both corporal punishment and pet ownership was 18.693 times that of those whose parents had no allergic diseases, experienced no corporal punishment, and did not keep pets (95%CI: 3.862 - 90.488,P<0.001). Conclusions TD comorbid with ADHD in children Results from the interaction of genetic and environmental factors. Parental allergic diseases combined with corporal punishment and pet ownership significantly increase the risk of ADHD comorbidity in children with TD.

Key words: tic disorder, attention-deficit/hyperactivity disorder, parental allergic disease, corporal punishment, keeping pets

中图分类号:

R179

陈熔, 蔡莹莹, 李沁瑜, 陈亮亮, 刘秀梅. 儿童抽动障碍共患注意缺陷多动障碍的影响因素及其联合作用研究[J]. 中国儿童保健杂志, 2025, 33(12): 1298-1302.

CHEN Rong, CAI Yingying, LI Qinyu, CHEN Liangliang, LIU Xiumei. Influencing factors and combined effects in children with tic disorder and comorbid attention-deficit/hyperactivity disorder[J]. Chinese Journal of Child Health Care, 2025, 33(12): 1298-1302.

参考文献

[1] American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSM-5[M]. Arlington: American Psychiatric Association,2013.
[2] Xu D,Liu L,Li H,et al. Potential role of ADRA2A genetic variants in the etiology of ADHD comorbid with tic disorders[J]. J Atten Disord,2021,25(1):33-43.
[3] Capetian P,Roessner V,Korte C,et al. Altered urinary tetrahydroisoquinoline derivatives in patients with Tourette syndrome: Reflection of dopaminergic hyperactivity?[J]. J Neural Transm (Vienna),2021,128(1):115-120.
[4] Mataix-Cols D,Isomura K,Brander G,et al. Early-life and family risk factors for tic disorder persistence into adulthood[J]. Mov Disord,2023,38(8):1419-1427.
[5] Liu F,Wang G,Ye J,et al. Sociodemographic and clinical characteristics of children with tic disorders and behavioral problems: A real-world study and development of a prediction model[J]. BMC Pediatr,2023,23(1):53.
[6] Chen L,Chen X,Ke N,et al. Association between allergic conjunctivitis and provisional tic disorder in children[J]. Int Ophthalmol,2020,40(1):247-253.
[7] Yu RL,Wang J,Wang XS,et al. Management of allergic rhinitis improves clinical outcomes of difficult-to-treat tic disorders or attention-deficit/hyperactivity disorders[J]. Allergol Select,2023,7:191-197.
[8] Park G,Jung YS,Park MK,et al. Melatonin inhibits attention-deficit/hyperactivity disorder caused by atopic dermatitis-induced psychological stress in an NC/Nga atopic-like mouse model[J]. Sci Rep,2018,8(1):14981.
[9] Huang J,Li R,Li L,et al. The relationship between allergic diseases and tic disorders: A systematic review and meta-analysis[J]. Neurosci Biobehav Rev,2022,132:362-377.
[10] Sharma M,Leung D,Momenilandi M,et al. Human germline heterozygous gain-of-function STAT6 variants cause severe allergic disease[J]. J Exp Med,2023,220(5):e20221755.
[11] Tsai SJ. Signal transducer and activator of transcription 6 (STAT6) and attention-deficit/hyperactivity disorder: A speculative hypothesis[J]. Med Hypotheses,2006,67(6):1342-1344.
[12] Xing X,Wang M,Wang Z. Parental corporal punishment in relation to children′s executive function and externalizing behavior problems in China[J]. Soc Neurosci,2018,13(2):184-189.
[13] Derella OJ,Burke JD,Stepp SD,et al. Reciprocity in undesirable parent-child behavior? Verbal aggression,corporal punishment,and girls′ oppositional defiant symptoms[J]. J Clin Child Adolesc Psychol,2020,49(3):420-433.
[14] Overgaauw PAM,Vinke CM,Hagen MAEV,et al. A one health perspective on the human-companion animal relationship with emphasis on zoonotic aspects[J]. Int J Environ Res Public Health,2020,17(11):3789.
[15] Ojwang V,Nwaru BI,Takkinen HM,et al. Early exposure to cats, dogs and farm animals and the risk of childhood asthma and allergy[J]. Pediatr Allergy Immunol,2020,31(3):265-272.
[16] Cassidy-Bushrow AE,Wegienka G,Havstad S,et al. Does pet-keeping modify the association of delivery mode with offspring body size?[J]. Matern Child Health J,2015,19(6):1426-1433.
[17] Cassidy-Bushrow AE,Sitarik AR,Johnson-Hooper TM,et al.Prenatal pet keeping and caregiver-reported attention deficit hyperactivity disorder through preadolescence in a United States birth cohort[J]. BMC Pediatr,2019,19(1):390.
[18] Miles J,Parast L,Babey S,et al. A propensity-score-weighted population-based study of the health benefits of dogs and cats for children[J]. Anthrozoös,2017,30 (3): 429-440.
[19] Abdolghanizadeh S,Salmeh E,Mirzakhani F,et al. Microbiota insights into pet ownership and human health[J]. Res Vet Sci,2024,171:105220.
[20] Wang Q,Yang Q,Liu X. The microbiota-gut-brain axis and neurodevelopmental disorders[J]. Protein Cell,2023,14(10):762-775.
[21] Li ZM,Robinson M,Kannan K. An assessment of exposure to several classes of pesticides in pet dogs and cats from New York,United States[J]. Environ Int,2022,169:107526.
[22] Tessari L,Angriman M,Díaz-Román A,et al. Association between exposure to pesticides and adhd or autism spectrum disorder: A systematic review of the literature[J]. J Atten Disord,2022,26(1):48-71.
[23] Platts-Mills TA,Keshavarz B,Wilson JM,et al. High risk of asthma among early teens is associated with quantitative differences in mite and cat allergen specific IgE and IgG4: A modified Th2 related antibody response revisited[J]. EBioMedicine,2025,112:105556.

儿童抽动障碍共患注意缺陷多动障碍的影响因素及其联合作用研究

Influencing factors and combined effects in children with tic disorder and comorbid attention-deficit/hyperactivity disorder

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	徐河, 支金草, 常庆, 王艳. 非侵入性迷走神经电刺激治疗注意缺陷多动障碍的潜在机制研究进展[J]. 中国儿童保健杂志, 2025, 33(8): 883-887.
[2]	姜含笑, 乔艺, 屈艳琳. 肠道菌群与注意缺陷多动障碍和孤独症谱系障碍的孟德尔随机化分析[J]. 中国儿童保健杂志, 2025, 33(7): 707-714.
[3]	张茜, 任姣姣, 高红, 白瑞北, 王朝晖. 近红外脑功能成像技术结合行为评估在注意缺陷多动障碍诊断中的效能分析[J]. 中国儿童保健杂志, 2025, 33(4): 402-408.
[4]	谭静, 陈立. 机器学习和深度学习在注意缺陷多动障碍诊断中的应用[J]. 中国儿童保健杂志, 2025, 33(4): 426-430.
[5]	段彩灵, 周雪, 刘丽君, 刘音池, 郭岚敏. 孤独症谱系障碍和注意缺陷多动障碍共患与鉴别[J]. 中国儿童保健杂志, 2025, 33(11): 1233-1239.
[6]	张莉莉, 尚莉丽, 崔何晴, 周冰原, 吴安琪. 基于孟德尔随机化研究分析炎性循环因子与抽动障碍发病风险的关系[J]. 中国儿童保健杂志, 2025, 33(11): 1261-1269.
[7]	郭英英, 张涛, 井亚丽, 王静, 杨长虹, 马杜婷, 薛永新, 杨琳, 张静. 儿童抽动障碍的临床与多导睡眠监测分析[J]. 中国儿童保健杂志, 2025, 33(11): 1270-1274.
[8]	毛广惠, 王丹, 李丽丽, 季忆婷, 王琪玉, 冯晨霞, 赵晓燕, 何璐, 蔡世忠, 陈艳. 学龄期注意缺陷多动障碍儿童的人体成分分析[J]. 中国儿童保健杂志, 2024, 32(9): 1029-1033.
[9]	邓梁琼, 梁媛媛, 岑诗, 胡敏, 李红辉, 曾烜, 廖林燕. 新森林教养方案对注意缺陷多动障碍儿童干预疗效的研究[J]. 中国儿童保健杂志, 2024, 32(8): 856-861.
[10]	章依文. 注意缺陷多动障碍共病智力障碍的诊治挑战[J]. 中国儿童保健杂志, 2024, 32(6): 581-585.
[11]	冯廷勇, 王雪珂. 注意缺陷多动障碍儿童多模态评估的现状与建议[J]. 中国儿童保健杂志, 2024, 32(6): 586-590.
[12]	刘子奇, 刘思奇, 陶梦娇, 任永颖, 李冠男, 孙静, 王昕, 张建昭, 杨健. 不同注意力、控制力水平注意缺陷多动障碍儿童认知功能特点[J]. 中国儿童保健杂志, 2024, 32(6): 591-596.
[13]	张琳琳, 吴赵敏, 王鹏, 操小兰, 刘娟, 王玉凤, 杨斌让. 高焦虑水平注意缺陷多动障碍儿童社会功能损害特征[J]. 中国儿童保健杂志, 2024, 32(6): 597-601.
[14]	郭春燕, 宋丽, 王亚哲, 于茹梦, 张定方, 殷梦华. 注意缺陷多动障碍共患学习障碍儿童的执行功能研究[J]. 中国儿童保健杂志, 2024, 32(6): 602-607.
[15]	卢鋆锋, 李甦. 注意缺陷多动障碍儿童语用性语言障碍研究进展[J]. 中国儿童保健杂志, 2024, 32(6): 643-647.