先天性肾上腺皮质增生症患儿行为问题及其影响因素  

Behavioral problems of children with congenital adrenal hyperplasia and their influencing factors

作　　者：颜玉 张星星[1] 陈曦 谭新睿 李师君[1] Yan Yu;Zhang Xingxing;Chen Xi;Tan Xinrui;Li Shijun(Department of Pediatrics,the Second Xiangya Hospital,Central South University,Changsha 410011,Hunan Province,China;Department of Child Psychology,Maternity and Children′s Healthcare Hospital of Zhuhai,Zhuhai 519000,Guangdong Province,China)

机构地区：[1]中南大学湘雅二医院儿科,长沙410011 [2]珠海市妇幼保健院儿童心理科,广东珠海519000

出　　处：《中华实用儿科临床杂志》2020年第20期1561-1565,共5页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的:研究先天性肾上腺皮质增生症(CAH)患儿的行为问题及其影响因素,为其防治提供依据。方法:采用病例对照研究方法,选取2017年6月1日至2019年3月31日在中南大学湘雅二医院门诊定期随访的25例湖南地区CAH患儿(年龄为4~16岁)(CAH组)为研究对象,以1∶2比例选取湖南地区年龄、性别匹配的健康儿童50例作为健康对照组,采用Achenbach儿童行为量表(CBCL)对所选对象的家长进行调查,评估儿童行为问题。应用SPSS 22.0软件进行统计学分析。结果:1.CAH组4~5岁男童外向化行为、攻击性因子及行为问题总分均高于健康对照组[(12.440±8.353)分比(5.060±5.230)分、(9.670±6.481)分比(4.110±4.157)分、(22.110±13.062)分比(12.890±9.405)分],差异均有统计学意义( t=2.829、2.711、2.109,均 P<0.05),其余CAH组患儿在行为问题总分及各因子方面与健康对照组比较差异均无统计学意义(均 P>0.05)。2.行为问题的影响因素为孕酮( β=0.567);睾酮为外向化和内向化问题的影响因素( β=0.582、0.497),并影响躯体诉述、违纪、社交退缩行为( β=0.735、0.531、0.492);影响分裂样的因素为初治年龄( β=0.402)。 结论:4~5岁CAH男童存在行为问题,其中攻击和外向化行为问题较为普遍。睾酮升高可能引起患儿内向化和外向化行为问题,其中躯体诉述、社交退缩、违纪受影响更大;孕酮升高则可能导致患儿的行为问题;初治年龄越大,分裂样问题可能越严重。Objective To investigate the behavioral problems of children with congenital adrenal hyperplasia(CAH),and to explore the influencing factors,thus providing evidence for their prevention and interventions.Methods A case-control study was carried out.A total of 25 children with CAH who were aged 4-16 and regularly followed up in the Outpatient Department of the Second Xiangya Hospital,Central South University from June 1,2017 to March 31,2019 were enrolled in the study group,and 50 age-and gender-matched healthy children in Hunan Province were selected as the healthy control group.The parents of the selected subjects were investigated with the Achenbach Child Behavior Checklist(CBCL)to evaluate children′s behavior problems.SPSS 22.0 software was applied to statistical analysis.Results(1)The scores of externalizing behaviors,aggressive factors and behavior problems in 4-to 5-year-old male children in the CAH group were significantly higher than those in the healthy control group[(12.440±8.353)scores vs.(5.060±5.230)scores,(9.670±6.481)scores vs.(4.110±4.157)scores,(22.110±13.062)scores vs.(12.890±9.405)scores](t=2.829,2.711,2.109,respectively,all P<0.05).There was no significant difference in the scores of other behavior problems and influencing factors between the CAH group and the healthy control group(all P>0.05).(2)The influencing factor of behavioral problems was progesterone(β=0.567).Testoste-rone not only was the influencing factor of externalizing and internalizing behaviors(β=0.582,0.497,respectively),but also affected the behavior of physical complaints,violation of discipline and social withdrawal(β=0.735,0.531 and 0.492,respectively).The factor influencing the schizoid behavior was the initial treatment age(β=0.402).Conclusions Four-to 5-year-old male children with CAH have behavioral problems,among which aggression and externalizing behaviors are more common.The increase of testosterone may cause the problems of internalizing and externalizing behaviors in children with CAH,and has a great i

关 键 词：先天性肾上腺皮质增生症 ACHENBACH儿童行为量表 行为问题 影响因素 儿童 

分 类 号：R725.8[医药卫生—儿科]