云南省3~6岁儿童多动行为及其与神经心理发育的关系  

Occurrence of hyperactivity behavior and its relationship with neuropsychological development in children aged 3-6 in Yunnan Province

作　　者：张晓雨 郭光萍[2] 安艳婷 车学继 王代娇 杨艳 刘云芬 汤四意 胡红卫 ZHANG Xiaoyu;GUO Guangping;AN Yanting;CHE Xueji;WANG Daijiao;YANG Yan;LIU Yunfen;TANG Siyi;HU Hongwei(School of Public Health of Kunming Medical University,Kunming(650500),Yunnan Province,China;不详)

机构地区：[1]昆明医科大学公共卫生学院,云南650500 [2]云南省妇幼保健院院办 [3]云南省妇幼保健院儿童保健科

出　　处：《中国学校卫生》2024年第8期1106-1110,共5页Chinese Journal of School Health

基　　金：国家“十三五”科技重大专项(2018ZX10715006-004);云南省卫生健康委员会医学后备人才培养计划项目(H-2019004)。

摘　　要：目的了解云南省3~6岁儿童多动行为检出情况,并探讨其与神经心理发育水平的关系,为儿童注意缺陷多动障碍(ADHD)的早期预防和干预提供线索。方法于2022年10月至2023年5月,采用分层随机抽样方法选取云南省5个州/市10所幼儿园1321名3~6岁儿童为研究对象,采用Conners教师症状问卷调查儿童多动行为,采用0岁~6岁儿童发育行为评估量表评估儿童大运动、精细动作、适应能力、语言和社会行为5个能区发育情况。采用Wilcoxon秩和检验、χ^(2)检验进行统计学分析,采用二分类Logistic回归分析儿童多动行为及其他行为问题与神经心理发育的关系。结果3~6岁儿童多动行为检出率为8.6%,男童、女童检出率分别为12.8%,4.1%(χ^(2)=31.53,P<0.01);3岁组儿童多动行为检出率为13.9%,高于4岁(9.2%)和5岁组儿童(7.0%)(χ^(2)=8.73,P<0.05);农村儿童注意力不集中-被动检出率(14.6%)高于城市(5.9%)(χ^(2)=22.23,P<0.01)。二分类Logistic回归分析结果显示,适应能力发育水平越高的儿童发生多动行为(OR=0.58,95%CI=0.39~0.86)的风险越低,同时多动(OR=0.57,95%CI=0.35~0.91)、品行问题(OR=0.57,95%CI=0.37~0.87)、注意力不集中-被动(OR=0.49,95%CI=0.33~0.74)的风险也越低;精细动作发育水平越高的儿童发生注意力不集中-被动(OR=0.59,95%CI=0.37~0.93)的风险越低(P值均<0.05)。结论男童多动行为及农村儿童注意力不集中-被动问题需要更多的关注。应加强儿童早期适应能力、精细动作训练,预防多动行为、注意力不集中等问题发生。Objective To investigate the prevalence of hyperactivity behavior in children aged 3-6 in Yunnan Province,to explore its relationship with neuropsychological development,so as to provide clues for early prevention and intervention of attention deficit hyperactivity disorder(ADHD)in children.Methods A total of 1321 children aged 3 to 6 from 10 kindergartens in 5 prefectures(cities)of Yunnan Province were selected by stratified random sampling method from October 2022 to May 2023.Teacher Rating Scale(TRS)was used to investigate children's hyperactive behavior and coexistent behavior.A qualified evaluator applied the Developmental Scale for Children Aged 0-6 Years to assess the development of 5 ability areas of gross motor movement,fine movement,adaptive ability,language and social behavior.Statistical analysis was performed using Wilcoxon rank sum test andχ^(2)test.Binary Logistic regression was applied to analyze the score of their hyperactivity behavior and its relationship with other behavior problems and neuropsychological development.Results The detection rate of hyperactivity behavior was 8.6%in children aged 3 to 6 years,12.8%in boys and 4.1%in girls(χ^(2)=31.53,P<0.01).The detection rate of hyperactivity in 3yearold children was 13.9%,which was higher than that in 4yearold(9.2%)and 5yearold children(7.0%)(χ^(2)=8.73,P<0.05).The detection rate of inattentionpassivity of rural children(14.6%)was higher than that of urban children(5.9%)(χ^(2)=22.23,P<0.01).Binary Logistic regression analysis showed that the higher the level of adaptive development,the lower the risk of hyperactivity(OR=0.58,95%CI=0.39-0.86),the higher the risk of hyperactivity(OR=0.57,95%CI=0.35-0.91),the higher the risk of conduct problems(OR=0.57,95%CI=0.37-0.87),inattentionpassivity(OR=0.49,95%CI=0.33-0.74)were also at lower risk(P<0.05).Children with higher levels of fine motor development had a lower risk of inattentionpassivity(OR=0.59,95%CI=0.37-0.93,P<0.05).Conclusions Hyperactivity in boys and inattentionpassivity in rural childre

关 键 词：注意力缺陷障碍伴多动 精神卫生 回归分析 儿童 学龄前 

分 类 号：R179[医药卫生—妇幼卫生保健] B844.1[医药卫生—公共卫生与预防医学] R748[哲学宗教—发展与教育心理学]