云南省3~6岁儿童多动行为及其与神经心理发育的关系

张晓雨; 郭光萍; 安艳婷; 车学继; 王代娇; 杨艳; 刘云芬; 汤四意; 胡红卫

doi:10.16835/j.cnki.1000-9817.2024254

云南省3~6岁儿童多动行为及其与神经心理发育的关系

doi: 10.16835/j.cnki.1000-9817.2024254

1.
昆明医科大学公共卫生学院, 云南 650500
2.
云南省妇幼保健院院办
3.
云南省妇幼保健院儿童保健科

基金项目:

国家"十三五"科技重大专项 2018ZX10715006-004

云南省卫生健康委员会医学后备人才培养计划项目 H-2019004

详细信息

作者简介:
张晓雨(1998-)，女，云南大理人，在读硕士，主要研究方向为妇幼保健

通讯作者:
胡红卫，E-mail: 15288336172@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 B844.1 R748
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- 被引次数: 0
出版历程
- 收稿日期: 2024-02-10
- 修回日期: 2024-03-31
- 刊出日期: 2024-08-25

Occurrence of hyperactivity behavior and its relationship with neuropsychological development in children aged 3-6 in Yunnan Province

1.
School of Public Health of Kunming Medical University, Kunming (650500), Yunnan Province, China

摘要

摘要: 目的了解云南省3~6岁儿童多动行为检出情况，并探讨其与神经心理发育水平的关系，为儿童注意缺陷多动障碍(ADHD)的早期预防和干预提供线索。方法于2022年10月至2023年5月，采用分层随机抽样方法选取云南省5个州/市10所幼儿园1 321名3~6岁儿童为研究对象，采用Conners教师症状问卷调查儿童多动行为，采用0岁~6岁儿童发育行为评估量表评估儿童大运动、精细动作、适应能力、语言和社会行为5个能区发育情况。采用Wilcoxon秩和检验、χ²检验进行统计学分析，采用二分类Logistic回归分析儿童多动行为及其他行为问题与神经心理发育的关系。结果 3~6岁儿童多动行为检出率为8.6%，男童、女童检出率分别为12.8%，4.1%(χ²=31.53，P < 0.01)；3岁组儿童多动行为检出率为13.9%，高于4岁(9.2%)和5岁组儿童(7.0%)(χ²=8.73，P < 0.05)；农村儿童注意力不集中-被动检出率(14.6%)高于城市(5.9%)(χ²=22.23，P < 0.01)。二分类Logistic回归分析结果显示，适应能力发育水平越高的儿童发生多动行为(OR=0.58，95%CI=0.39~0.86)的风险越低，同时多动(OR=0.57，95%CI=0.35~0.91)、品行问题(OR=0.57，95%CI=0.37~0.87)、注意力不集中-被动(OR=0.49，95%CI=0.33~0.74)的风险也越低；精细动作发育水平越高的儿童发生注意力不集中-被动(OR=0.59，95%CI=0.37~0.93)的风险越低(P值均 < 0.05)。结论男童多动行为及农村儿童注意力不集中-被动问题需要更多的关注。应加强儿童早期适应能力、精细动作训练，预防多动行为、注意力不集中等问题发生。
- 注意力缺陷障碍伴多动 /
- 精神卫生 /
- 回归分析 /
- 儿童, 学龄前
Abstract: Objective To investigate the prevalence of hyperactivity behavior in children aged 3-6 in Yunnan Province, to explore its relationship with neuropsychological development, so as to provide clues for early prevention and intervention of attention deficit hyperactivity disorder (ADHD) in children. Methods A total of 1 321 children aged 3 to 6 from 10 kindergartens in 5 prefectures (cities) of Yunnan Province were selected by stratified random sampling method from October 2022 to May 2023. Teacher Rating Scale (TRS) was used to investigate children's hyperactive behavior and co-existent behavior. A qualified evaluator applied the Developmental Scale for Children Aged 0-6 Years to assess the development of 5 ability areas of gross motor movement, fine movement, adaptive ability, language and social behavior. Statistical analysis was performed using Wilcoxon rank sum test and χ² test. Binary Logistic regression was applied to analyze the score of their hyperactivity behavior and its relationship with other behavior problems and neuropsychological development. Results The detection rate of hyperactivity behavior was 8.6% in children aged 3 to 6 years, 12.8% in boys and 4.1% in girls (χ²=31.53, P < 0.01). The detection rate of hyperactivity in 3-year-old children was 13.9%, which was higher than that in 4-year-old (9.2%) and 5-year-old children (7.0%) (χ²=8.73, P < 0.05). The detection rate of inattention-passivity of rural children (14.6%) was higher than that of urban children (5.9%) (χ²=22.23, P < 0.01). Binary Logistic regression analysis showed that the higher the level of adaptive development, the lower the risk of hyperactivity (OR=0.58, 95%CI=0.39-0.86), the higher the risk of hyperactivity (OR=0.57, 95%CI=0.35-0.91), the higher the risk of conduct problems (OR=0.57, 95%CI=0.37-0.87), inattention-passivity (OR=0.49, 95%CI=0.33-0.74) were also at lower risk (P < 0.05). Children with higher levels of fine motor development had a lower risk of inattention-passivity (OR=0.59, 95%CI=0.37-0.93, P < 0.05). Conclusions Hyperactivity in boys and inattention-passivity in rural children requires more attention. It is necessary to strengthen children's early adaptive ability and fine motor training to prevent hyperactive behavior and inattention.
- Attention dificit disorder with hyperactivity /
- Mental health /
- Regression analysis /
- Child, preschool
注释:

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表 1 不同性别儿童多动指数及TRS各因子得分比较[M(P₂₅，P₇₅)]

Table 1. Comparison of scores for CIH and TRS factors in children of different sex[M(P₂₅, P₇₅)]

性别	人数	多动指数	品行问题	多动	注意力不集中-被动
男	688	0.60(0.20, 1.00)	0.38(0.13, 0.88)	0.57(0.14, 1.00)	0.63(0.25, 1.00)
女	633	0.40(0.20, 0.70)	0.38(0.13, 0.63)	0.43(0.14, 0.71)	0.50(0.13, 0.88)
Z值		-5.51	-3.89	-5.86	-4.26
P值		＜0.01	＜0.01	＜0.01	＜0.01

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表 2 不同组别儿童多动行为及TRS各因子检出率比较

Table 2. Comparison of the detection rates of hyperactivity behavior and TRS factors in children of different groups

组别	选项	例数	统计值	多动行为	品行问题	多动	注意力不集中-被动
性别	男	688		88(12.8)	48(7.0)	42(6.1)	45(6.5)
	女	633		26(4.1)	37(5.8)	29(4.6)	54(8.5)
			χ²值	31.53	0.70	1.50	1.88
			P值	＜0.01	0.40	0.22	0.17
年龄/岁	3	173		24(13.9)	18(10.4)	14(8.1)	34(19.7)
	4	444		41(9.2)	33(7.4)	28(6.3)	35(7.9)
	5	704		49(7.0)	34(4.8)	29(4.1)	30(4.3)
			χ²值	8.73	8.28	5.45	47.60
			P值	0.01	0.02	0.07	＜0.01
区域	城市	1 075		86(8.0)	64(6.0)	54(5.0)	63(5.9)
	农村	246		28(11.4)	21(8.5)	17(6.9)	36(14.6)
			χ²值	2.90	2.22	1.40	22.23
			P值	0.09	0.14	0.24	＜0.01
注：()内数字为检出率/%。

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表 3 多动与非多动行为儿童神经心理发育迟缓检出率比较

Table 3. Comparison of neuropsychological developmental delay in children with hyperactivity and non-hyperactive behaviors

组别	人数	大运动	精细动作	适应能力	语言	社会行为	总发育商
非多动行为	1 207	36(3.0)	92(7.6)	107(8.9)	45(3.7)	53(4.4)	16(1.3)
多动行为	114	8(7.0)	18(15.8)	22(19.3)	11(9.6)	9(7.9)	7(6.1)
χ²值		4.09	9.10	12.87	8.99	2.86	11.44
P值		0.04	＜0.01	＜0.01	＜0.01	0.09	＜0.01
注：()内数字为检出率/%。

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表 4 儿童神经心理发育水平与多动行为及TRS的Logistic回归分析(n=1 321)

Table 4. Logistic regression analysis of neuropsychological development level, hyperactivity behavior and TRS(n=1 321)

自变量与常量	多动行为			品行问题			多动			注意力不集中-被动
自变量与常量	Wald χ²值	P值	OR值(95%CI)	Wald χ²值	P值	OR值(95%CI)	Wald χ²值	P值	OR值(95%CI)	Wald χ²值	P值	OR值(95%CI)
大运动	0.00	0.98	1.01(0.66~1.55)	0.01	0.95	1.02(0.63~1.64)	0.58	0.45	1.22(0.73~2.05)	2.56	0.11	0.69(0.43~1.09)
精细动作	0.30	0.59	0.88(0.57~1.38)	1.96	0.16	0.71(0.44~1.15)	0.00	0.98	1.01(0.58~1.75)	5.21	0.02	0.59(0.37~0.93)
适应能力	7.20	＜0.01	0.58(0.39~0.86)	6.83	＜0.01	0.57(0.37~0.87)	5.46	0.02	0.57(0.35~0.91)	11.64	＜0.01	0.49(0.33~0.74)
语言	1.82	0.18	1.38(0.87~2.19)	0.00	0.96	0.99(0.58~1.67)	0.27	0.61	1.16(0.66~2.05)	0.14	0.71	0.91(0.55~1.51)
社会行为	1.73	0.19	0.75(0.48~1.15)	0.81	0.37	0.80(0.49~1.30)	0.22	0.64	1.13(0.68~1.89)	1.96	0.16	0.71(0.44~1.15)
总发育商	0.88	0.35	0.65(0.27~1.60)	0.32	0.57	1.31(0.51~3.38)	3.32	0.07	0.37(0.13~1.08)	0.17	0.68	1.21(0.48~3.06)
常量	2.98	0.08	6.06	0.29	0.59	0.55	0.02	0.88	1.19	0.17	0.68	1.52

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