抽动障碍患儿的生活质量状况及其影响因素分析  

Analysis of quality of life and related influencing factors among children with tic disorders

作　　者：刘芳[1] 姚宝珍[1] 王军陵[1] 刘宏[1] 叶静萍[1] 王高华[2] Liu Fang;Yao Baozhen;Wang Junling;Liu Hong;Ye Jingping;Wang Gaohua(Department of Pediatrics,Renmin Hospital of Wuhan University,Wuhan 430060,China;Department of Psychiatry,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院儿科,430060 [2]武汉大学人民医院精神科,430060

出　　处：《神经疾病与精神卫生》2022年第10期691-699,共9页Journal of Neuroscience and Mental Health

基　　金：武汉大学医学腾飞计划(TFLC2018001)。

摘　　要：目的分析抽动障碍患儿的生活质量及其影响因素。方法纳入2019年6月至2020年12月在武汉大学人民医院儿科门诊首次诊断为抽动障碍的150例4~15岁儿童青少年为抽动障碍组,随机选取在我院儿童保健门诊同期就诊的年龄、性别匹配的150名健康体检儿童为健康对照组,收集两组的一般和临床资料。采用耶鲁综合抽动严重程度量表(YGTSS)、Achenbach儿童行为量表(CBCL)评估抽动障碍患儿的抽动和行为状况,采用儿童生活质量普通适用核心量表4.0中文版(PedsQL)评估两组的生活质量。采用广义线性模型分析抽动障碍患儿PedsQL总分及各部分评分的影响因素。结果抽动障碍组患儿PedsQL的社会心理领域评分低于其生理领域评分,学校表现评分低于健康对照组儿童,差异有统计学意义(P<0.05)。广义线性模型结果显示,抽动障碍患儿的PedsQL生理功能(生理领域)评分与民主型教养方式(β=0.102,95%CI=0.009~0.196)、行为正常(β=0.094,95%CI=0.020~0.168)呈正相关(P<0.05);情感功能评分与平时体质良好(β=0.128,95%CI=0.006~0.250)、母亲文化程度为高中(β=0.118,95%CI=0.018~0.217)或初中及以下(β=0.137,95%CI=0.038~0.236)、行为正常(β=0.170,95%CI=0.087~0.253)呈正相关(P<0.05);社交功能、社会心理领域评分均与行为正常(β=0.106、0.154;95%CI=0.039~0.172、0.091~0.217)呈正相关(P<0.05);学校表现评分与父亲文化程度为初中及以下(β=-0.172,95%CI=-0.303~-0.041)呈负相关,与行为正常(β=0.246,95%CI=0.147~0.344)呈正相关(P<0.05);PedsQL总分与轻度抽动障碍(β=0.062,95%CI=0.006~0.119)、行为正常(β=0.135,95%CI=0.077~0.192)呈正相关(P<0.05)。结论抽动障碍患儿的学校表现差于健康儿童,抽动障碍患儿的生活质量与其平时体质、教养方式、父母亲文化程度以及共患行为问题存在相关性。Objective To analyze the quality of life among children with tic disorders and the influencing factors.Methods A total of 150 children and adolescents aged from 4 to 15 years were enrolled in tic disorders group,who were first diagnosed with tic disorders in the Pediatric Outpatient Department of Renmin Hospital of Wuhan University from June 2019 to December 2020.Another 150 age-and gender-matched healthy children who underwent health examinations during the same period in the Child Healthcare Department of the same hospital were randomly selected as the control group.The Yale Comprehensive Tic Severity Scale(YGTSS)and the Achenbach Child Behavior Scale(CBCL)were used respectively to assess the tic disorders and behavioral status of all research subjects.The Pediatric Quality of Life Inventory 4.0,Generic Core Scales of the Chinese version(PedsQL)was used to assess the quality of life of the two groups.The generalized linear model was used to analyze the influencing factors of PedsQL total score and each part score in children with tic disorder.Results The subscale score of social-psychological domain of PedsQL was lower than the subscale score of physical domain among children with tic disorders.The subscale score of school performance of PedsQL in tic disorders group was significantly lower than that in control group(P<0.05).The results of the generalized linear models showed that the subscale score of physical functioning(physical domain)in tic disorders cases was positively correlated with democratic parenting pattern(β=0.102,95%CI=0.009-0.196)and normal behavior(β=0.094,95%CI=0.020-0.168)(P<0.05).The subscale score of emotional functioning was positively correlated with personal physical fitness(β=0.128,95%CI=0.006-0.250),the education level of the mother is high school(β=0.118,95%CI=0.018-0.217)or middle school and below(β=0.137,95%CI=0.038-0.236),and normal behavior(β=0.170,95%CI=0.087-0.253)(P<0.05).The subscale scores of social functioning and social-psychological domain were positively correlated

关 键 词：抽动障碍 儿童 生活质量 行为 

分 类 号：R749.94[医药卫生—神经病学与精神病学]