目的 分析儿童注意缺陷多动障碍(ADHD)影响因素及骨密度与体格生长的相关性,为ADHD的预防或早期干预提供新思路。方法 纳入2020年6月—2022年6月昆明市儿童医院116例ADHD患儿为观察组,另取同期健康体检儿童80例为对照组,对比两组临床资料,经多因素Logistic回归分析儿童ADHD的影响因素。依据性别将ADHD患儿分为男童组与女童组,测量两组患儿骨密度与体格生长(身高、体重)状况,并分析二者间相关性。结果 观察组男童、母亲孕期不良行为、母亲高中以下文化程度、批评家庭教育方式占比及父母压力指数高于对照组(χ2=14.430、5.689、5.630、6.738,t=6.936,P＜0.05),家庭环境评分低于对照组(t=6.328,P＜0.05)。经Logistic回归分析结果显示,男童(OR=3.298,95%CI:1.759～6.184)、母亲孕期不良行为(OR=2.730,95%CI:1.169～6.375)、母亲高中以下文化程度(OR=2.032,95%CI:1.127～3.663)、批评家庭教育方式(OR=2.349,95%CI:1.223～4.513)、父母压力指数(OR=1.089,95%CI:1.055~1.124)与儿童发生ADHD呈正相关(P＜0.05),家庭环境评分与儿童发生ADHD呈负相关(OR=0.868,95%CI:0.820～0.919,P＜0.05)。男童组与女童组骨密度、身高、体重比较,差异无统计学意义(P＞0.05);经Pearson相关性分析,结果显示,骨密度与身高、体重呈正相关(r=0.409、0.317,P＜0.05)。结论 儿童ADHD的发生与性别、母亲孕期不良行为、家庭教养环境等多种因素有关;ADHD儿童生长发育过程中骨密度与体格生长密切相关,临床可针对上述因素采取对应干预措施,以预防或早期干预ADHD。
Abstract
Objective To analyze the contributing factors of attention deficit hyperactivity disorder (ADHD) in children and the correlation between bone mineral density and physical growth, in order to provide new clues for the prevention and early intervention of ADHD. Methods A total of 116 children with ADHD were included into the observation group from June 2020 to June 2022, while another 80 healthy children in the same period were included as the control group.Clinical data of the two groups were compared, and the factors influencing ADHD in children were analyzed using multivariate Logistic regression. Children with ADHD were further divided into boys group and girls group based on gender. Bone mineral density (BMD) and physical growth (height and body weight) of the two groups were measured, and the correlation between the two was analyzed. Results In the observation group, the proportion of boys, maternal bad behaviors during pregnancy, their educational level below high school, critical parenting, and parental stress index were significantly higher compared to the control group (χ2=14.430, 5.689, 5.630, 6.738, t=6.936, P<0.05). Additionally, family environment score was significantly lower than that in the control group (t=6.328, P<0.05). Logistic regression analysis revealed that factors including boys (OR=3.298, 95%CI: 1.759 - 6.184), maternal bad behaviors during pregnancy (OR=2.730, 95%CI: 1.169 - 6.375), maternal education level of senior high school or below (OR=2.032, 95%CI: 1.127 - 3.663), critical parenting (OR=2.349, 95%CI: 1.223 - 4.513), and parental stress index (OR=1.089, 95%CI: 1.055 - 1.124) were positively correlated with ADHD in children (P<0.05), while family environment score was negatively related to ADHD (OR=0.868, 95%CI: 0.820 - 0.919, P<0.05). There were no significant differences in BMD, height and body weight between boys and girls in ADHD group (P>0.05). Pearson correlation analysis indicated a positive correlation of BMD with height and body weight (r=0.409, 0.317, P<0.05). Conclusions The development of ADHD in children is associated with gender, maternal bad behavior during pregnancy, family parental style and so on. Bone mineral density is closely related to physical growth in children with ADHD, clinical interventions can be implemented to prevent or early intervene ADHD.
关键词
注意缺陷多动障碍 /
骨密度 /
体格生长
Key words
attention deficit hyperactivity disorder /
bone mineral density /
physical growth
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基金
昆明市卫生健康委员会卫生科研课题项目(2021-06-04-003);云南省科技厅基础研究计划昆医联合专项-面上项目(202101AY070001-218);昆明市第二批“春城计划”春城名医专项(C202012011);昆明市卫生科技人才培养项目暨“十百千”工程省内知名专家[2020-SW (省) -28];云南省王艺专家工作站(2019IC050);昆明市卫生科技人才培养“十百千”后备人选 [2021-SW(后备)-68];昆明市卫生健康委员会卫生科研课题(2022-06-01-006)
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