气道过敏性疾病对学龄儿童注意缺陷多动障碍患病风险的影响  

Impact of allergic airway diseases on risk of attention deficit hyperactivity disorder in school.age children

作　　者：江晓东[1] 沈春[2] 李珂[3] 季忆婷 李生慧[2] 江帆[3] 沈晓明[2] 李斐[4] 胡燕[1] Jiang Xiaodong Shen Chun Li Ke Ji Yiting Li Shenghui Jiang Fan Shen Xiaoming Li Fei Hu Yan(Department of Primary Child Health Care, Children＇s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China)

机构地区：[1]重庆医科大学附属儿童医院儿保科儿童发育疾病研究教育部重点实验室儿童发育重大疾病国家国际科技合作基地儿科学重庆市重点实验室,400014 [2]教育部与上海市环境与儿童健康重点实验室 [3]上海交通大学附属上海儿童医学中心发育行为儿科 [4]上海交通大学附属新华医院发育行为儿保科教育部与上海市环境与儿童健康重点实验室

出　　处：《中华儿科杂志》2017年第7期509-513,共5页Chinese Journal of Pediatrics

摘　　要：目的探讨气道过敏性疾病对学龄儿童注意缺陷多动障碍（ADHD）患病风险的影响。方法采用分层整群抽样方法，在全国随机选取上海、广州、西安、武汉等9个城市作为调查点，调查对象为1～6年级在校学龄儿童，集中于2005年11至12月完成家长问卷调查，问卷包括学龄儿童个人及家庭社会环境问卷（包括ADHD及过敏性鼻炎、支气管哮喘诊断史）和儿童睡眠习惯问卷（CSHQ）。依据有无专科医生确诊的过敏性鼻炎及支气管哮喘进行分组作为自变量，包括无气道过敏性疾病（无过敏性鼻炎和支气管哮喘）组、单一气道过敏性疾病（过敏性鼻炎或支气管哮喘）组、混合气道过敏性疾病（过敏性鼻炎合并支气管哮喘）组，以有无专科医生确诊ADHD作为因变量，建立二分类Logistic回归模型，分析学龄儿童ADHD的危险因素。结果调查中6个年级共发出问卷23 791份，回收完整问卷22 018份；其中男10 869名，女11 021名，性别记录缺失128名；平均年龄（8.8±1.8）岁。单一气道过敏性疾病组患儿ADHD患病风险为2.197[95%可信区间（CI）：1.823～2.648]，混合气道过敏性疾病组患儿ADHD患病风险为3.150（95%CI：2.082～4.760）。对睡眠因素校正后，单一和混合气道过敏患儿ADHD患病风险分别为2.055（95%CI：1.683～2.508）和3.140（95%CI：2.061～4.784），与校正睡眠因素前比较差异无统计学意义。结论气道过敏性疾病增加儿童ADHD的患病风险，两者相关性不依赖于睡眠介导，气道过敏性疾病是儿童ADHD的独立危险因素。ObjectiveTo investigate the impact of allergic airway diseases on the risk of attention deficit hyperactivity disorder （ADHD） in school-age children.MethodUsed stratified cluster sampling method, school-age children in first to sixth grade in primary schools in 9 randomly selected cities including Shanghai, Guangzhou, Xi′an, and Wuhan were enrolled in the study. Interview of parents with questionnaires, which included school-age individual and family social environment questionnaire （including history of diagnosed ADHD, allergic rhinitis, and bronchial asthma） and Children′s Sleep Habits Questionnaire （CSHQ）, were finished and collected during November to December in 2005.Diagnosed allergic rhinitis and asthma by specialist were independent variables and divided into following three categories as no allergic diseases （neither allergic rhinitis nor asthma）, single allergic disease （allergic rhinitis or asthma）, and combined allergic diseases （allergic rhinitis and asthma）. Diagnosed ADHD as dependent variable, binary logistic regress model was used to analyze the risks of ADHD in school-age children.ResultTotally 23 791 questionnaires were handed out, while 22 018 were collected. The children had an average age of （8.8±1.8） years, within which 10 869 were male, and 11 021 were female. The risk ratios of ADHD were 2.197 （95%CI： 1.823-2.648） and 3.150 （95%CI： 2.082-4.760） in children with single allergic disease and combined allergic diseases separately. There was no significant difference after adjusting for the factor of sleep habits, as the risk ratios were 2.055 （95%CI： 1.683-2.508） and 3.140 （95%CI： 2.061-4.784） in children with single and combined allergic airway disease separately.Conclusion Allergic rhinitis and bronchial asthma increased the risk of ADHD, not depending on sleep habits. Hence, allergic airway diseases could be independent risk factors of ADHD.

关 键 词：注意力缺陷障碍伴多动 睡眠 危险因素 气道过敏性疾病 

分 类 号：R749.94[医药卫生—神经病学与精神病学]