本文選題：兒童注意力缺陷多動障礙　切入點：膳食結(jié)構(gòu)　出處：《蘇州大學》2008年碩士論文　論文類型：學位論文

【摘要】： 目的:從注意力缺陷多動障礙(attention deficit hyperactivity disorder,ADHD)兒童營養(yǎng)、兒童忽視及神經(jīng)營養(yǎng)因子方面,探討ADHD兒童發(fā)病的有關(guān)因素,為兒童ADHD開展有效的防治措施提供科學的依據(jù)。 方法:采取自愿的原則,選取至本院兒童保健科就診的6～10歲兒童,符合美國精神障礙診斷與統(tǒng)計手冊第4版(DSM-IV)有關(guān)ADHD的診斷標準,為研究組,同時按照性別及年齡進行1:1配對選取健康兒童為正常對照組。 采用瑞文標準智力測驗、整合視聽連續(xù)執(zhí)行測試(Integrared Visual and Auditory Continous Performance text,IVA-CPT)評估受試兒童的智商以及對ADHD進行分型;采用飲食調(diào)查、血清微量元素、血氨、血液酸堿度及相關(guān)生化指標的測定來評定受試兒童的膳食結(jié)構(gòu),營養(yǎng)元素、血氨水平及體液酸堿平衡;采用《中國城區(qū)兒童忽視狀況評價問卷》評價受試兒童存在的兒童忽視情況,對影響ADHD的身體、情感、教育、安全、醫(yī)療五個層面的忽視進行Logistic多元回歸分析;采用酶聯(lián)免疫ELISA法對受試兒童血清中S100β蛋白含量進行測定,評價受試兒童大腦發(fā)育成熟狀況。 結(jié)果:本研究表明①ADHD組兒童熱量攝入量、蛋白質(zhì)和脂肪供熱比顯著高于正常組兒童,碳水化合物供熱比顯著低于正常組兒童。 ②ADHD組兒童血清鎂元素和鋅元素含量均低于正常組兒童,而血清鈣、鐵、銅三種微量元素含量無顯著差異性。 ③ADHD兒童的血氨水平顯著高于正常組兒童。 ④ADHD組兒童血液PH值均在正常范圍內(nèi)為7.39±0.03,但較正常組兒童7.41±0.02偏酸性,與體液酸堿平衡相關(guān)的SB、Na+和Cl-水平在ADHD組兒童均高于正常組兒童。 ⑤多動癥組兒童受忽視人數(shù)、忽視度顯著多于正常組兒童,并且ADHD組兒童身體、情感、教育、醫(yī)療的忽視分值高于正常組兒童,而安全層面忽視分值無顯著性差異。 ⑥6～10歲正常學齡期兒童S100β蛋白含量無性別和年齡差異,平均含量為42.71 pg/ml,標準差為10.76 pg/ml。 ⑦ADHD組兒童血清S100β蛋白含量低于正常組兒童,各亞型間血清S100β蛋白含量無顯著差異性;兒童的智商和IVT-CPT各商數(shù)與血清S100β蛋白含量具有顯著的正相關(guān)。 結(jié)論:本研究顯示①兒童膳食結(jié)構(gòu)不合理,營養(yǎng)不均衡,體液酸堿平衡紊亂是ADHD發(fā)病的誘發(fā)因素。 ②ADHD與兒童忽視有關(guān),其中情感、教育、醫(yī)療層面的忽視是ADHD發(fā)病的主要因素。 ③本研究中6～10歲正常學齡期兒童S100β蛋白的含量,可供臨床應用。 ④ADHD兒童血清中S100β蛋白的含量明顯較低,表明S100β蛋白與ADHD有關(guān),進一步提示ADHD與大腦發(fā)育障礙有關(guān)。
[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 鹵0.03 in normal range, but 7.41 鹵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.
【學位授予單位】：蘇州大學
【學位級別】：碩士
【學位授予年份】：2008
【分類號】：R749.94

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