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目的测定不同亚型的注意力缺陷多动障碍(ADHD)患儿血清铁蛋白(SF)、Hb、血铅水平,探讨其在ADHD发病中的变化。方法采用《美国精神病学会精神障碍分类法》(第4版)(DSM-Ⅳ)标准,并结合Conner′s量表和视听整和连续执行测试法进行诊断,选择2008年8-12月本院儿科门诊确诊为ADHD的患儿53例。其中注意力缺陷型20例,混合型18例,多动-冲动型15例,同期选择来本院行体检的健康儿童18例作为健康对照组。抽取清晨空腹静脉血进行Hb、SF及血铅水平测定,应用SPSS 11.0软件对其进行统计学分析。结果1.ADHD患儿各亚组SF水平均低于健康对照组,差异均有统计学意义(Pa<0.05),其中注意力缺陷型亚组SF水平下降明显,均低于混合型和多动-冲动型亚组(Pa<0.05)。2.ADHD患儿各亚组间血铅水平无显著性差异;各亚组与健康对照组比较,血铅水平差异亦均无统计学意义(Pa>0.05)。3.ADHD患儿各亚组间Hb水平无显著性差异;各亚组与健康对照组比较,Hb水平差异亦均无统计学意义(Pa>0.05)。结论ADHD尤其是注意力缺陷型患儿的发病可能与低水平SF有关,在诊治此类型患儿时应常规检测,并及早纠正。
Objective To determine the levels of serum ferritin (SF), Hb, and blood lead in children with attention deficit / hyperactivity disorder (ADHD) in different subtypes and to explore their changes in the pathogenesis of ADHD. Methods According to the American Psychiatric Association Classification of Mental Disorders (4th edition) (DSM-Ⅳ), combined with Conner’s scale and video-audio-visual and continuous exercise test, the hospital was selected from August to December 2008 Pediatric outpatient diagnosis of ADHD in 53 children. There were 20 cases of attention deficit, 18 cases of mixed type and 15 cases of hyperactivity-impulsive type, and 18 healthy children selected for our hospital during the same period as the healthy control group. Fasting venous blood samples were taken for determination of Hb, SF and blood lead levels, and SPSS 11.0 software was used for statistical analysis. SF level in children with ADHD was significantly lower than that in healthy children (P <0.05), SF level in attention-deficient subgroup decreased significantly, both were lower than those in mixed type and hyperactivity group - impulsive subgroup (Pa <0.05). There was no significant difference in blood lead levels among all subgroups of children with ADHD. There was no significant difference in blood lead levels between each subgroup and healthy controls (Pa> 0.05). There was no significant difference in Hb levels among all the subgroups of children with ADHD. There was no significant difference in Hb levels between each subgroup and the healthy control group (Pa> 0.05). Conclusion The incidence of ADHD, especially in children with attention deficit disorder, may be related to the low level of SF. Children with this type of ADHD should be routinely tested and corrected as soon as possible.