儿童注意力缺陷多动障碍诱发因素研究

发布时间：2018-03-18 00:34

本文选题：儿童注意力缺陷多动障碍　切入点：膳食结构　出处：《苏州大学》2008年硕士论文　论文类型：学位论文

【摘要】： 目的:从注意力缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童营养、儿童忽视及神经营养因子方面,探讨ADHD儿童发病的有关因素,为儿童ADHD开展有效的防治措施提供科学的依据。方法:采取自愿的原则,选取至本院儿童保健科就诊的6～10岁儿童,符合美国精神障碍诊断与统计手册第4版(DSM-IV)有关ADHD的诊断标准,为研究组,同时按照性别及年龄进行1:1配对选取健康儿童为正常对照组。采用瑞文标准智力测验、整合视听连续执行测试(Integrared Visual and Auditory Continous Performance text,IVA-CPT)评估受试儿童的智商以及对ADHD进行分型;采用饮食调查、血清微量元素、血氨、血液酸碱度及相关生化指标的测定来评定受试儿童的膳食结构,营养元素、血氨水平及体液酸碱平衡;采用《中国城区儿童忽视状况评价问卷》评价受试儿童存在的儿童忽视情况,对影响ADHD的身体、情感、教育、安全、医疗五个层面的忽视进行Logistic多元回归分析;采用酶联免疫ELISA法对受试儿童血清中S100β蛋白含量进行测定,评价受试儿童大脑发育成熟状况。结果:本研究表明①ADHD组儿童热量摄入量、蛋白质和脂肪供热比显著高于正常组儿童,碳水化合物供热比显著低于正常组儿童。 ②ADHD组儿童血清镁元素和锌元素含量均低于正常组儿童,而血清钙、铁、铜三种微量元素含量无显著差异性。 ③ADHD儿童的血氨水平显著高于正常组儿童。 ④ADHD组儿童血液PH值均在正常范围内为7.39±0.03,但较正常组儿童7.41±0.02偏酸性,与体液酸碱平衡相关的SB、Na+和Cl-水平在ADHD组儿童均高于正常组儿童。 ⑤多动症组儿童受忽视人数、忽视度显著多于正常组儿童,并且ADHD组儿童身体、情感、教育、医疗的忽视分值高于正常组儿童,而安全层面忽视分值无显著性差异。 ⑥6～10岁正常学龄期儿童S100β蛋白含量无性别和年龄差异,平均含量为42.71 pg/ml,标准差为10.76 pg/ml。 ⑦ADHD组儿童血清S100β蛋白含量低于正常组儿童,各亚型间血清S100β蛋白含量无显著差异性;儿童的智商和IVT-CPT各商数与血清S100β蛋白含量具有显著的正相关。结论:本研究显示①儿童膳食结构不合理,营养不均衡,体液酸碱平衡紊乱是ADHD发病的诱发因素。 ②ADHD与儿童忽视有关,其中情感、教育、医疗层面的忽视是ADHD发病的主要因素。 ③本研究中6～10岁正常学龄期儿童S100β蛋白的含量,可供临床应用。 ④ADHD儿童血清中S100β蛋白的含量明显较低,表明S100β蛋白与ADHD有关,进一步提示ADHD与大脑发育障碍有关。
[Abstract]:Objective: to explore the related factors of children with ADHD from the aspects of attention deficit hyperactivity disorder (deficit hyperactivity ADHD), child neglect and neurotrophic factors, so as to provide scientific basis for effective prevention and treatment of ADHD in children. Methods: according to the diagnostic criteria of DSM-IV4 of the American Handbook for the diagnosis and Statistics of Mental Disorders, 60-year-old children from the Children's Health Department of our hospital were selected as the study group, according to the voluntary principle. At the same time, 1: 1 matched healthy children as normal control group according to sex and age. Raven standard intelligence test was used to evaluate the intelligence quotient (IQ) and type of ADHD (IVA-CPT) of children tested by integrated audiovisual Visual and Auditory Continous Performance Performance IVA-CPT, and dietary survey, serum trace elements, blood ammonia, blood ammonia were used to evaluate the intelligence quotient of the children. To evaluate the dietary structure, nutritional elements, blood ammonia level and humoral acid-base balance of the children by the determination of blood pH and related biochemical indexes. The children neglect status of children in urban area of China was evaluated by the questionnaire of Child neglect in China. The Logistic multiple regression analysis was carried out on the neglect affecting the body, emotion, education, safety and medical treatment of the children. The content of S100 尾 protein in serum of children was determined by enzyme linked immunosorbent assay (ELISA). Results: the results showed that the caloric intake, the ratio of protein and fat heating in ADHD group were significantly higher than those in normal group, and the carbohydrate heating ratio was significantly lower than that in normal group. 2 the contents of mg and Zn in serum of children in ADHD group were lower than those in normal children, but there were no significant differences among the three trace elements in serum calcium, iron and copper. 3 the blood ammonia level of ADHD children was significantly higher than that of normal children. 4 the blood PH values in ADHD group were 7.39 卤0.03 in normal range, but 7.41 卤0.02 were slightly acidic than those in normal group. The levels of SBN Na and Cl- related to humoral acid-base balance in ADHD group were higher than those in normal group. (5) the number of children neglected in ADHD group was significantly higher than that in normal group, and the neglect scores of children in ADHD group were higher than those in normal group, but there was no significant difference in safety level neglect score. There was no difference in S100 尾 protein content between sexes and ages in 66 ~ 10 years old normal school-age children. The average S100 尾 protein content was 42.71 PG / ml, and the standard deviation was 10.76 PG / ml. 7The content of serum S100 尾 protein in children in ADHD group was lower than that in normal group, but there was no significant difference among the subtypes, and there was a significant positive correlation between the intelligence quotient (IQ) and IVT-CPT quotient of children and the content of serum S100 尾 protein. Conclusion: 1 unreasonable dietary structure, unbalanced nutrition and disturbance of acid-base balance in humoral fluid are the inducing factors of ADHD in children. 2 ADHD is related to child neglect, among which affective, educational and medical neglect are the main factors in the pathogenesis of ADHD. 3 the content of S100 尾 protein in 6 ~ 10 years old normal school-age children is available for clinical application. 4the content of S100 尾 protein in serum of children with ADHD was significantly lower, which indicated that S100 尾 protein was related to ADHD, and further suggested that ADHD was related to cerebral dysplasia.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R749.94

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