学龄前儿童哮喘与睡眠障碍对注意缺陷多动障碍症状发生的协同效应  

Synergistic effect of asthma and sleep disorders on attention-deficit/hyperactivity disorder in preschool children

作　　者：严双琴 高国朋 顾春丽 曹慧 汪素美 倪玲玲[2] 陶慧慧[2] 邵婷[2] 陶芳标[2] YAN Shuang-qin;GAO Guo-peng;GU Chun-li(Department of Child Health,Maternity and Child Health Care Hospital of Ma'anshan City,Ma'anshan,Anhui Province 243011,China;不详)

机构地区：[1]马鞍山市妇幼保健院儿童保健科,安徽243011 [2]安徽医科大学儿少卫生与妇幼保健学系

出　　处：《中国公共卫生》2021年第5期824-828,共5页Chinese Journal of Public Health

基　　金：国家自然科学基金(81330068);安徽省预防医学与公共卫生科研课题[2011Y0110]。

摘　　要：目的探讨学龄前儿童哮喘与睡眠障碍对ADHD症状发生的影响。方法2014年4—6月选择安徽马鞍山市区16439名3~6岁在幼儿园的学龄前儿童作为研究对象,通过问卷调查由儿童主要带养人回顾经医院确诊的儿童哮喘病史、儿童睡眠问题发生情况,采用Conners父母症状问卷评估学龄前儿童ADHD症状。采用非条件logistic回归分析影响作用。结果哮喘和睡眠障碍相互调整的同时,进一步控制母亲文化程度、独生子女、户口、性别、年龄、每日看电视时间、被动吸烟等因素,学龄前儿童哮喘和睡眠障碍与ADHD症状正向关联(OR_(哮喘)=1.45,95%CI=1.11~1.89;OR_(睡眠障碍)=2.88,95%CI=2.56~3.25);学龄前儿童哮喘伴睡眠障碍者ADHD症状的发生风险为(OR=4.3,95%CI:3.06~6.04),分别高于有哮喘不伴睡眠障碍者(OR=1.35,95%CI=0.88~2.07)和无哮喘仅有睡眠障碍者(OR=2.86,95%CI=2.53~3.24),协同作用指数为1.49。结论学龄前儿童哮喘和睡眠障碍对ADHD症状的发生存在协同作用。Objective To explore synergistic effect of asthma and sleep disorders on attention-deficit/hyperactivity disorder(ADHD)in preschool children.Methods We conducted a survey among 16439 children aged 3–6 years and their primary caregivers recruited in 91 of 93 kindergartens registered in Ma’anshan city of Anhui province between April and June2016.Information on sleep disorders and medically diagnosed asthma in the children were collected with a self-designed questionnaire;the Conners′10-Item Abbreviated Symptom Questionnaire–Chinese version(ASQ-C)was administered to assess ADHD symptoms.Unconditional logistic regression was adopted to analyze the synergistic effect.Results After adjusting for interactive effect of asthma and sleep disorders and potential confounders such as maternal education,being a only child,registered permanent residence,gender,age,daily time of watching television,and passive smoking,asthma and sleep disorders were positively associated with ADHD symptoms(adjusted odd ratio[a OR]for asthma:1.45,95%confidence interval[95%CI]:1.11–1.89;a OR for sleep disorders:2.88,95%CI:2.56–3.25)in the children.The children with both asthma and sleep disorder had a higher risk of ADHD symptoms(OR=4.3,95%CI:3.06–6.04)compared to those only with asthma(OR=1.35,95%CI:0.88–2.07)and those only with sleep disorder(OR=2.86,95%CI:2.53–3.24).The synergy index of asthma and sleep disorders on ADHD was 1.49 in the children.Conclusion Asthma and sleep disorder has a synergistic effect on the occurrence of ADHD symptoms in preschool children.

关 键 词：哮喘 睡眠障碍 ADHD 儿童 学龄前 

分 类 号：R179[医药卫生—妇幼卫生保健]