目的 探讨儿童注意缺陷多动障碍与哮喘及过敏性疾病的关系, 为寻找注意缺陷多动障碍病因提供依据。方法 采用1∶1匹配病例对照研究, 对278例注意缺陷多动障碍儿童和278例正常儿童进行哮喘及过敏性疾病的调查。对相关的危险因素采用单因素χ2检验, 多因素条件Logistic回归分析。结果 病例组儿童哮喘、湿疹患病率与对照组差异无统计学意义(2.9%与1.1%和4.3%与1.8%, P>0.05);病例组有持续6个月发痒/疹子、曾经诊断鼻炎、近一年有哮喘症状的、及经常有流涕、眼痒、鼻塞等过敏现象的发生率显著性高于对照组(P<0.05)。条件Logistic回归分析, 过敏性鼻炎(P=0.029, OR=2.021, 95%CI:1.074~3.803)及经常有流涕、眼痒、鼻塞(P=0.012, OR=1.863, 95%CI:1.147~3.024)是ADHD的危险因素。结论 儿童注意缺陷多动障碍与过敏性鼻炎及经常有流涕、眼痒、鼻塞的发生存在相关性, 而与哮喘及湿疹发生的关系需进一步研究确定。
Abstract
Objective To explore the association between attention deficit hyperactivity disorder (ADHD) and asthma and allergic disease in children. Methods A 1∶1 matched case-control study of 278 children with ADHD and 278 normal children were investigated in asthma and allergic disease.The Chi-square test was used to test single factors while multi-factors inspection was test by conditional Logistic regression analysis. Results The suffering from asthma and eczema in cases and control group had no significant difference (2.9% vs 1.1%, 4.3% vs 1.8%, respectively, P>0.05).The incidence of allergic phenomenon such as itchy rash for six months, once diagnosed rhinitis, recent one year to have asthma symptom, and often have a runny nose, itchy eyes, nasal congestion were significantly higher than those of control group (P<0.05).Allergic rhinitis (P=0.029, OR=2.021, 95%CI:1.074~3.803), and often have a runny nose, eye itching, nasal congestion (P=0.012, OR=1.863, 95%CI:1.147~3.024) were risk factors for ADHD by conditional Logistic regression analysis. Conclusions Allergic rhinitis with a runny nose, itchy eyes, nasal congestion are associated with ADHD.Further studies need to be done in exploring the relationship of asthma or eczema with ADHD.
关键词
注意缺陷多动障碍 /
哮喘 /
过敏性疾病 /
儿童
Key words
attention deficit hyperactivity disorder /
asthma /
allergic rhinitis /
children
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Masoli M, Fabian D, Holt S, et al.The global burden of asthma:executive summary of the GINA Dissemination Committee report[J].Allergy, 2004, 59(5):469-478.
[2] 全国儿童哮喘防治协作组.中国城区儿童哮喘患病率调查[J].中华儿科杂志, 2003, 41(2):123-127.
[3] 黄东明, 肖晓雄, 李德乐, 等.支气管哮喘儿童行为问题的研究[J].中国儿童保健杂志, 2008, 16(2):144-149.
[4] Ten-Brinke A, Ouwerkerk ME, Zwindeman, et al.Psychopathology jn patient with severe asthma is associated with increased health care utilization[J].AMJ Respir Crit Med, 200l, 163(5):1093-1096.
[5] Polanczy KG, de Lima MS, Horta BL, et al.The worldwide prevalence of ADHD:a systematic review and meta regression analysis[J].Psychiatry, 2007, 164(6):942-948.
[6] 郑毅.儿童注意缺陷多动障碍防治指南[M].北京:北京大学出版社, 2007:1-23.
[7] Pelsser LM, Buitelaar JK, Savelkoul HF.ADHD as a (non) allergic hypersensitivity disorder:A hypothesis[J].Pediatric Allergy and Immunology, 2009, 20:107-112.
[8] References.The global burden of asthma report[R].www.Ginasthma.com.Accessed May 26, 2004.
[9] Trond R, Tomas ME, Anders L, et al.Comorbidity of asthma with ADHD[J].J Atten Disord, 2011, 15(7):564-571.
[10] Ole BF, Anne H, Tomas ME, et al.Adult attention deficit hyperactivity disorder isassociated with asthma[J].BMC Psychiatry, 2011, 11:128-134.
[11] Mogensen N, Larsson H, Lundholm C, et al.Association between childhood asthma and ADHD symptoms in adolescence-a prospective population-based twin study[J].Allergy, 2011, 66(9):1224-1230.
[12] Bender BG, Ikle DN, DuHamel T, et al.Neuropsychological and behavioral changes in asthmatic children treated with beclomethasone dipropionate versus theophylline[J].Pediatrics, 1998, 101:355-360.
[13] Biederman J, Milberger S, Faraone SV, et al.Associations between childhood asthma and ADHD:Issues of psychiatric comorbidity and familiality[J].Journal of the American Academy of Child and Adolescent Psychiatry, 1994, 33:842-848.
[14] Hammerness P, Monuteaux MC, Faraone SV, et al.Reexamining the familial association between asthma and ADHD in girls[J].J Atten Disord, 2005, 8(3):136-143.
[15] 刘应波, 程冬兰, 赖忠华.广东佛山市顺德区乐从镇过敏性鼻炎儿童发病情况及其生活质量的调查[J].新医学, 2012, 41(5):293-295.
[16] Pretorius E.Asthma medication may influence the psychological functioning of children[J].Med Hypotheses, 2004, 63(3):409-413.
基金
广东省医学科学技术研究基金(A2012289);广州市荔湾区科技计划项目(20121214015-2)
PDF(424 KB)
