CAJ | 학술논문

目的：了解兰州市区6～13岁学龄期儿童注意缺陷多动障碍（ADHD）的患病率及相关因素，为有效预防和治疗学龄期 ADHD 提供依据。方法分别在兰州市四区（城关、七里河、安宁、西固）采用 Conners 父母症状问卷（PSQ）对6～13岁学龄期儿童进行分层整群随机抽样调查。经 PSQ 筛查为阳性的儿童由小儿神经、心理行为专科医师排除智力障碍、合并其他神经或精神等疾病，依据美国精神病诊断统计手册第四版（DSM-IV）诊断标准确诊ADHD；采用 SPSS17．0软件对家长填写的 ADHD 影响因素调查表进行统计学分析，完成 ADHD 相关因素调查。结果共发放调查问卷3826份，收回有效问卷3604份。其中男童1826人（50．7％），年龄（9．45±1．41）岁；女童1778人（49．3％），年龄（9．33±1．75）岁。ADHD 总患病率为10．63％（383例），其中男童占13．91％高于女童的7．25％（χ2＝36．982，P ＜0．001）；6～7岁、8～9岁、10～11岁、12～13岁组患病率比较差异无统计学意义（χ2＝2．225，P ＞0．05）。ADHD 各亚型的患病率：注意缺陷为主型（ADHD-PI）7．13％、多动／冲动为主型（ADHD-HI）1．02％、混合型（ADHD-CT）2．46％，各亚型的患病率比较差异有统计学意义（χ2＝214．739，P ＜0．001）。性别差异（男）、窒息史、中枢系统疾病史、语言发育史、学习成绩、孕期抑郁焦虑症、母孕期吸烟史、家庭经济收入、母亲的年龄和文化程度、父母与子女的关系、儿童零食／冷饮习惯、儿童日常生活习惯／体育锻炼习惯、以及儿童的主要抚养人等是影响 ADHD 的相关因素。结论兰州市区学龄期儿童 ADHD 患病率为10．63％，以 ADHD-PI 型为主。生物学和家庭环境因素间的交互作用影响 ADHD 的发生。弱势群体家庭的儿童是 ADHD 重点防治对象。
목적：료해란주시구6～13세학령기인동주의결함다동장애（ADHD）적환병솔급상관인소，위유효예방화치료학령기 ADHD 제공의거。방법분별재란주시사구（성관、칠리하、안저、서고）채용 Conners 부모증상문권（PSQ）대6～13세학령기인동진행분층정군수궤추양조사。경 PSQ 사사위양성적인동유소인신경、심리행위전과의사배제지력장애、합병기타신경혹정신등질병，의거미국정신병진단통계수책제사판（DSM-IV）진단표준학진ADHD；채용 SPSS17．0연건대가장전사적 ADHD 영향인소조사표진행통계학분석，완성 ADHD 상관인소조사。결과공발방조사문권3826빈，수회유효문권3604빈。기중남동1826인（50．7％），년령（9．45±1．41）세；녀동1778인（49．3％），년령（9．33±1．75）세。ADHD 총환병솔위10．63％（383례），기중남동점13．91％고우녀동적7．25％（χ2＝36．982，P ＜0．001）；6～7세、8～9세、10～11세、12～13세조환병솔비교차이무통계학의의（χ2＝2．225，P ＞0．05）。ADHD 각아형적환병솔：주의결함위주형（ADHD-PI）7．13％、다동／충동위주형（ADHD-HI）1．02％、혼합형（ADHD-CT）2．46％，각아형적환병솔비교차이유통계학의의（χ2＝214．739，P ＜0．001）。성별차이（남）、질식사、중추계통질병사、어언발육사、학습성적、잉기억욱초필증、모잉기흡연사、가정경제수입、모친적년령화문화정도、부모여자녀적관계、인동령식／랭음습관、인동일상생활습관／체육단련습관、이급인동적주요무양인등시영향 ADHD 적상관인소。결론란주시구학령기인동 ADHD 환병솔위10．63％，이 ADHD-PI 형위주。생물학화가정배경인소간적교호작용영향 ADHD 적발생。약세군체가정적인동시 ADHD 중점방치대상。
ABSTRACT:Objective To investigate the prevalence of attention deficit hyperactivity disorder (ADHD)and its related factors among school children aged 6-13 years in Lanzhou city,and to provide the basis for effective prevention and treatment of ADHD in school-age children.Methods The Parent Symptom Questionnaire(PSQ)was used to take stratified random samples of 6-13-year-old school children in four areas of Lanzhou city(Chengguan district,Qilihe district,Anning district,and Xigu district).Mental retardation and other neurological or psychiatric diseases were excluded by pediatric neurologists and psychologists in PSQ-positive children.The ADHD was definitely diagnosed according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders(DSM-IV).SPSS 17.0 software was used to analyze the data of related factors for ADHD.Results Of the 3 826 questionnaires issued,3604 were analyzed effectively,including 1 826 boys(50.7%,average age(9.45±1.41)years)and 1 778 girls(49.3%,average age(9.33± 1.75)years).A total of 383 children(10.63%)had ADHD.The prevalence of ADHD among boys (13.91%)was significantly higher than that among girls 7.25%(χ2 =36.982,P <0.001).Fur-thermore,the prevalence of ADHD among children aged 6-7,8-9,10-11 or 12-13 years was no sig-nificant differences in ADHD prevalence were found among children of different ages(χ2=2.225, P > 0.05 ).The incidences of predominantly inattentive (ADHD-PI ),hyperactive-impulsive (ADHD-HI)and combined(ADHD-CT)subtypes were 7.13%,1.02% and 2.46%,respectively. The differences were significant among children with different ADHD subtypes(χ2 = 214.739, P <0.001).The related factors for ADHD included gender(male),history of asphyxia,history of central nervous system diseases,history of language development,learning achievement,antenatal depression and anxiety,history of smoking during pregnancy,family income,mother’s age and ed-ucational level,relationship between parents and children,intake of snacks or cold drinks,daily life habits/ physical exercise,and main dependents.Conclusion The prevalence of ADHD is 10.63% among school-age children in Lanzhou city,and ADHD-PI is the main subtype.The inter-action between biological factors and family environment factors affects the occurrence of ADHD. Children in vulnerable families are the focus of prevention and treatment of ADHD.