摘要
注意缺陷多动障碍(ADHD)是儿童和青少年时期最常见的慢性神经发育性疾病,是一种高度可遗传的疾病,但并非所有的风险因素都是遗传引起的,据估计,有10%~40%的差异是由环境因素造成的,是由遗传和环境共同作用引起的,目前仍不清楚具体发病机制,但多种危险因素可以导致其发生率增高,因此研究其发病的危险因素对儿童ADHD的早期诊断和预防有重要的意义。本文从孕期父母年龄及受孕前母体肥胖、孕期母亲精神障碍、发热、甲状腺功能异常、先兆子痫及哮喘,孕期、学龄前期物质暴露、父母受教育水平低、家庭收入低、教养方式不合理、轻微脑损伤等方面论述其与ADHD发病之间的联系,旨在指导临床减少暴露,以期为后续研究提供借鉴。针对以上高危因素,加强孕期保健、构建和谐的家庭关系、避免学龄前儿童脑功能损害及相关物质暴露、治疗原发病等措施是降低儿童及青少年ADHD发病率的必要举措,ADHD是由多因素共同作用的结果,从多角度审视ADHD的发生是亟须面对的。
Attention-deficit hyperactivity disorder(ADHD)is a most common chronic neurodevelopmental disease in children and adolescents.It is a highly genetic disease,but not all risk factors are genetic.It is estimated that 10%to 40%differences are related to environmental factors,and are the result of the co-action of genetic and environmental factors.At present,the specific pathogenesis is still not clear,but multiple risk factors can lead to the increase of its incidence.Therefore,it is of great significance to the early diagnosis and prevention of ADHD to study the risk factors of its incidence.This paper discusses the association between incidence of ADHD and the following factors:parents'age at pregnancy and mothers being obese before pregnancy,mental disorder of mothers during pregnancy,fever,abnormal thyroid function,preeclampsia and asthma,material exposure during pregnancy and preschool period,low education level of parents,low family income,improper raising and educational methods,and mild brain damage.The aim is to guide the clinicians to reduce exposure and provide references for the later studies.Regarding the above-mentioned high-risk factors,the necessary measures to reduce the incidence of ADHD in children and adolescents include:to strengthen health care during pregnancy,to build harmonious family relationship,to avoid brain function damage and exposure of related materials in preschool period,and to treat primary diseases.ADHD is the result of multiple factors acting together,so it is necessary to manage the incidence of ADHD from multiple aspects.
作者
李赛
樊秋月
刘旭华
姜永红
LI Sai;FAN Qiuyue;LIU Xuhua;JIANG Yonghong(Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)
出处
《中国中西医结合儿科学》
2023年第5期410-415,共6页
Chinese Pediatrics of Integrated Traditional and Western Medicine
基金
上海市“十三五”临床重点专科中医儿科项目(shslcdzk04102)
上海市进一步加快中医药传承创新发展三年行动计划(2021~2023年)(ZY[2021-2023]-0206-01)
上海市卫生健康委员会临床研究专项(202240158)。
关键词
注意缺陷多动障碍
危险因素
儿童
Attention deficit hyperactivity disorder
Risk factors
Children
