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。
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.
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
Key words
tic disorder /
attention-deficit/hyperactivity disorder /
parental allergic disease /
corporal punishment /
keeping pets
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基金
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)
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