Abstract: Objective To analyze the effect of methylphenidate hydrochloride prolonged-release tablets on the growth and nutritionl intake of children with attention deficit hyperactivity disorder (ADHD), in order to provide scientific reference for drug therapy of ADHD. Methods ADHD children in Children′s Hospital of Nanjing Medical University were selected as study subjects, and were divided into treatment group and control group. The treatment group was given methylphenidate hydrochloride sustained release tablets, while the control group received behavior management. Height, weight, body composition measurement and 24 hour dietary survey analysis were monitored regularly. Results The Z scores of weigh-for-age(W/A-Z) (t= 5.815, 6.708, 5.003, 2.234, P<0.001) andthe Z scores of body mass index-for-age(BMI/A-Z) (t=3.776, 4.666, 6.431, 7.467, P<0.001), body composition measurement of protein content (t=3.789, 4.087, 3.098, 2.889, P=0.001), skeletal musclecontent (t=3.112, 2.890, 4.765, 5.221, P<0.001),fat content (t=4.329, 3.879, 2.998, 2.567, P<0.001); 24-hour dietary assessment of energy (t=11.657, 12.887, 5.091, 3.765, P<0.001), protein (t=12.987, 14.098, 13.777, 12.987, P<0.001), fat (t= 12.889, 12.012, 14.887, 13.987, P<0.001) and carbohydrate intake (t= 13.889, 14.889, 15.098, 14.889, P<0.001)after 3-month,6-month,9-month,and 12-month treatmentwere lower than those in control group. The Z scrores of height-for-age (H/A-Z) of children in the treatment groupafter 6-month, 9-month and 12-month treatment were lower than those in control group(t=1.752, 2.625,5.961,P＜0.001). Repeated measurement anova analysis showed that the time effect, intragroup effect and interaction effect of physical assessment, body composition (except for inorganic salts) and 24-hour dietary assessment between the treatment group and control group were statistically significant (P<0.05). Conclusion The medication of methylphenidate hydrochloride prolonged-release tablets on ADHD children, with the treatment duration increasing, will have an impact on the height, weight, BMI and nutritionl intake of children.

Key words: attention-deficit hyperactivity disorder, medication, growth, children

摘要： 目的 探讨盐酸哌甲酯缓释片对注意缺陷多动障碍(ADHD)儿童生长的影响,以期为ADHD的药物治疗提供科学依据。方法 选择2020年1月—2021年12月南京医科大学附属儿童医院就诊的ADHD儿童为研究对象,分为治疗组(盐酸哌甲酯缓释片治疗)和对照组(行为管理治疗)。定期监测儿童生长情况,包括身高、体质量、人体成分和24h膳食评估。结果 在完成3个月、6个月、9个月、12个月治疗时,治疗组儿童年龄的体质量Z评分(W/A-Z)(t=5.815、6.708、5.003、2.234,P<0.001)、年龄的体质量指数Z评分(BMI)/A-Z(t=3.776、4.666、6.431、7.467,P＜0.001)、人体成分蛋白质含量(t=3.789、4.087、3.098、2.889,P＜0.001)、骨骼肌含量(t=3.112、2.890、4.765、5.221,P<0.001)、脂肪含量(t=4.329、3.879、2.998、2.567,P＜0.001);24h膳食评估的能量(t=11.657、12.887、5.091、3.765,P＜0.001)、蛋白质(t=12.987、14.098、13.777、12.987,P＜0.001)、脂肪(t=12.889、12.012、14.887、13.987,P＜0.001)和碳水化合物(t=13.889、14.889、15.098、14.889,P＜0.001)的摄入比对照组低。治疗6个月、9个月、12个月后儿童的年龄的身高Z评分(H/A-Z)比对照组低(t=1.752、2.625、5.961,P＜0.001)。重复测量方差分析结果显示,两组患儿体格评估、人体成分(无机盐除外)、24h膳食评估的时间效应、组内效应与交互作用差异均有统计学意义(P＜0.05)。结论 随着治疗时间的延长,盐酸哌甲酯缓释片治疗对ADHD儿童的身高、体质量、BMI、人体成分和宏量营养素的摄入会产生一定影响。

关键词: 注意缺陷多动障碍, 药物治疗, 生长, 儿童