论文摘要
目的1、分析注意缺陷多动障碍（Attention deficit hyperactivity disorder,ADHD）儿童血清多巴胺、去甲肾上腺素的水平。2、探讨儿童ADHD发生的有关影响因素。3、研究儿童ADHD的心理行为特征。4、评价儿童ADHD脑电生物反馈训练的治疗效果。方法1、中枢神经递质检测利用德国进口的多巴胺、去甲肾上腺素试剂盒,运用ELISA方法分析ADHD儿童血清多巴胺、去甲肾上腺素的水平。2、影响因素采用1:1配对病例对照研究,运用问卷调查方法分析儿童ADHD的有关影响因素。3、心理行为特征运用1:1配对病例对照研究,采取心理行为评价量表分析儿童ADHD的心理行为特征。4、脑电生物反馈训练采用美国生产的ProComp+/BioGraph脑电生物反馈系统,分析儿童ADHD脑电生物反馈训练治疗前后视听整合连续性行为测试（Intermediate visual andauditory continuous performance test,IVA-CPT）各项指标,评价儿童ADHD脑电生物反馈训练的治疗效果。结果1、中枢神经递质检测病例组儿童血清多巴胺和去甲肾上腺素水平分别为1.42±0.34 ng/ml和177.70±37.92 pg/ml,对照组儿童分别为1.94±0.42 ng/ml和206.20±42.45pg/ml;与对照组儿童比较,病例组儿童血清多巴胺、去甲肾上腺素水平均具有显著性差异（P<0.05）。2、影响因素在131例ADHD儿童中,男女童之比为2.0:1,发病高峰主要集中在8～10岁,随着年龄的增长,儿童ADHD的构成比逐渐减少;经配对x2检验,存在显著性差异的影响因素分别为父亲文化程度、儿童按时睡眠习惯、家庭人口数、父亲玩牌、父母间的关系、父母与子女间的关系、居室装修后入住时间、父亲性格、儿童孤僻、多疑、任性、烦恼和孤独,经配对t检验,存在显著性意义的影响因素分别为父亲年龄、母亲年龄、儿童每周尿床次数、儿童血锌、铁和铅水平;经单因素条件Logistic回归分析,儿童ADHD的影响因素分别为父亲年龄、母亲年龄、儿童每周尿床次数、居室装修后入住时间、儿童任性、烦恼和孤独、儿童血锌和铁水平;经多因素条件Logistic回归分析,儿童ADHD的影响因素按贡献大小依次为儿童孤独、儿童每周尿床次数和居室装修后入住时间。3、心理行为特征病例组儿童智商（Intelligence quotient,IQ）为99.92±15.44,对照组儿童为106.96±11.93,均处于正常水平;病例组儿童语文和数学成绩优秀率明显低于对照组;病例组儿童尿床、经常独自呆着、动作缓慢、非常不安、不能长时间静坐、经常破坏自己或别人东西、经常欺负别人或同学、粗心、容易激动或勃然大怒、神经质阳性率明显高于对照组儿童;经单因素条件Logistic回归分析,病例组儿童主要表现为经常独自呆着、动作缓慢、非常不安、不能长时间静坐、经常破坏自己或别人东西、经常欺负别人或同学、粗心和神经质;经多因素条件Logistic回归分析,病例组儿童主要表现为经常独自呆着和不能长时间静坐。4、脑电生物反馈训练在60例儿童ADHD中,脑电生物反馈训练的有效率为91.6%;治疗前后儿童以注意缺陷为主型ADHD综合注意力商数（FAQ）分别为70.10±11.79和93.35±17.05,以多动冲动为主型ADHD综合反应控制商数（FRCQ）分别为75.10±10.98和95.25±10.94,混合型ADHD综合注意力商数（FAQ）分别为58.05±16.53和79.50±23.03,且综合反应控制商数（FRCQ）分别为68.90±11.47和96.15±16.05;经配对t检验,治疗前后儿童以注意缺陷为主型、以多动冲动为主型和混合型ADHD的IVA-CPT指标均显著提高（P<0.001）。结论分析ADHD儿童血清中枢神经递质水平及影响因素;研究儿童ADHD的心理行为特征,早期评价儿童ADHD;建议以社区为单位,以ADHD儿童、家长、老师和医生为团队,采取以脑电生物反馈训练为主的综合性措施,开展儿童ADHD的控制与干预工作。
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标签：儿童论文; 中枢神经递质论文; 影响因素论文; 脑电生物反馈训练论文;