包头蒙古族儿童注意缺陷多动障碍及与头发中微量元素的关系
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摘要
目的了解包头市蒙古族儿童注意缺陷多动障碍与毛发中不同元素的关系,为预防儿童注意缺陷多动障碍提供理论依据。方法于2014年3月至2015年3月分别选择包头市市区及旗县区具有代表性的3所纯蒙古族小学1 000名二至六年级在校学生为研究对象,首先采用Conners儿童行为问卷中的教师问卷(简化版)对被试进行注意缺陷多动障碍筛查,再采用美国精神病学协会制定的《精神障碍诊断和统计手册》修订版(DSM-Ⅳ)的诊断标准进行诊断,同时选取同校、同年级、同性别、相互间无血缘关系的儿童作为健康对照组。对不同组儿童毛发中铜、锌、锰、铅、镉、砷、汞、硒8种元素的含量进行实验室检测。结果 1 000名蒙古族儿童中,儿童注意缺陷多动障碍的发生人数共38例,发生率为3.8%,其中男生30例,发生率为3.0%;女生8例,发生率为0.8%,差异有统计学意义(χ2=8.631,P<0.05);二至六年级儿童注意缺陷多动障碍发生率分别为0.2%,0.3%,0.8%,1.3%,1.2%,差异有统计学意义(χ2=12.824,P<0.05)。儿童注意缺陷多动障碍组发样中铜、铅、镉、铜锌比值均高于健康组,锌元素含量低于健康组,差异均有统计学意义(t值分别为-2.814,-4.785,-3.627,-4.117,2.105,P值均<0.05)。结论包头市蒙古族儿童注意缺陷多动障碍男生发生率高于女生且主要集中在小学高年级,蒙古族注意缺陷多动障碍儿童毛发中元素含量异常。预防少数民族地区儿童注意缺陷多动障碍应关注平时的元素摄入。
Objective To explore possible relation between attention deficit hyperactivity disorder with multiple elements in hair among Mongolian students from Inner Mongolia. Methods A total of 1 000 students( 460 boys and 540 girls) from three Mongolian primary schools were investigated. The Conners Child Behavior Checklist( teacher report version) was used to assess attention deficit hyperactivity disorder( ADHD) according to Diagnostic and Statistical Manual of Mental Disorders Revised Edition( DSM-Ⅳ). Control healthy students were selected from the same grade, same sex. Hair copper, zinc, manganese, lead, cadmium, arsenic, mercury, selenium level was assessed. Results Prevalence of ADHD was 3.8%( n = 38), with 30 boys. Significant differences were found by grades( grade 2 to grade 6: 0.2%, 0. 3%, 0. 8%, 1. 3%, 1. 2%, χ~2= 12. 824, P < 0. 05). Hair copper and lead in children with ADHD was higher than healthy group( t =-2.814,-4.785, P<0.05), hair cadmium and copper zinc ratio was found higher in ADHD students( t =-3.627,-4.117, P<0.05). Hair zinc was lower than the healthy group( t = 2.105, P<0.05). Conclusion Attention deficit hyperactivity disorder is high among Mongolian boys and high grades in primary school. Hair copper, lead,cadmium and copper zinc ratio is higher among attention deficit hyperactivity disorder children.
Objective To explore possible relation between attention deficit hyperactivity disorder with multiple elements in hair among Mongolian students from Inner Mongolia. Methods A total of 1 000 students( 460 boys and 540 girls) from three Mongolian primary schools were investigated. The Conners Child Behavior Checklist( teacher report version) was used to assess attention deficit hyperactivity disorder( ADHD) according to Diagnostic and Statistical Manual of Mental Disorders Revised Edition( DSM-Ⅳ). Control healthy students were selected from the same grade, same sex. Hair copper, zinc, manganese, lead, cadmium, arsenic, mercury, selenium level was assessed. Results Prevalence of ADHD was 3.8%( n = 38), with 30 boys. Significant differences were found by grades( grade 2 to grade 6: 0.2%, 0. 3%, 0. 8%, 1. 3%, 1. 2%, χ~2= 12. 824, P < 0. 05). Hair copper and lead in children with ADHD was higher than healthy group( t =-2.814,-4.785, P<0.05), hair cadmium and copper zinc ratio was found higher in ADHD students( t =-3.627,-4.117, P<0.05). Hair zinc was lower than the healthy group( t = 2.105, P<0.05). Conclusion Attention deficit hyperactivity disorder is high among Mongolian boys and high grades in primary school. Hair copper, lead,cadmium and copper zinc ratio is higher among attention deficit hyperactivity disorder children.
引文
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[11]孙桂香,王炳花,张亚峰.血清锌与儿童注意缺陷多动障碍关系的Meta分析[J].中国当代儿科杂志,2015,17(9):980-983.
[12]曹丽新.重金属毒物镉对儿童健康的影响[J].国际儿科学杂志,2013,40(6):603-606.
[13]辛晓昱,吴媛,冀永娟,等.注意缺陷多动障碍与儿童血铅水平的关系研究[J].中国儿童保健杂志,2011,19(5):465-467.
[14]毋嫘,叶知新,张炯理,等.铅污染对儿童行为与神经功能的影响[J].中国妇幼保健,2012,27(10):1582-1586.
[2]向伟.微量营养素与儿童的认知发展[J].中国儿童保健杂志,2012,20(2):100-102,111.
[3]田霖,梁凤超,陈实,等.汞暴露与小学生神经行为功能相关性的研究[J].环境与健康杂志,2015,32(12):1035-1041.
[4]石荣兴,芦然,吴岩,等.丰台区256名小学生体内重金属含量与智力和神经行为的相关性分析[J].中国妇幼保健,2015,30(14):2231-2234.
[5]汪向东,王希林,马弘.心理卫生评定量表手册[M].增订版.北京:中国心理卫生杂志社,1999:52-54,161-167.
[6]张道龙,等(译).精神障碍诊断与统计手册:案头参考书[M].5版.北京:北京大学出版社,2014:25-28.
[7]静进.儿童注意缺陷多动障碍诊疗进展[J].实用儿科临床杂志,2012,27(12):965-970.
[8]金文岚,阿依努尔·吾买尔,杜亚松,等.上海市闸北区5~15岁儿童注意缺陷多动障碍患病率及其影响因素的研究[J].上海精神医学,2010,22(4):211-216.
[9]张建裕,龚华.2094例儿童微量元素铅、镉、铜含量分析[J].中国妇幼保健,2012,27(1):69-70.
[10]牟文凤,宋金莲,丁伟.注意缺陷多动障碍体内铅、锌、铁含量的监测分析[J].中国儿童保健杂志,2013,21(1):106-109.
[11]孙桂香,王炳花,张亚峰.血清锌与儿童注意缺陷多动障碍关系的Meta分析[J].中国当代儿科杂志,2015,17(9):980-983.
[12]曹丽新.重金属毒物镉对儿童健康的影响[J].国际儿科学杂志,2013,40(6):603-606.
[13]辛晓昱,吴媛,冀永娟,等.注意缺陷多动障碍与儿童血铅水平的关系研究[J].中国儿童保健杂志,2011,19(5):465-467.
[14]毋嫘,叶知新,张炯理,等.铅污染对儿童行为与神经功能的影响[J].中国妇幼保健,2012,27(10):1582-1586.