抽動(dòng)及共患注意缺陷多動(dòng)障礙患兒維生素D含量差異研究

［摘 要］目的 探討血清維生素D含量與抽動(dòng)障礙（TD）發(fā)病及共患注意缺陷多動(dòng)障礙（ADHD）的關(guān)系。方法 選取2021年4月至2023年4月于攀枝花市中心醫(yī)院兒科門(mén)診確診為T(mén)D的161名兒童為研究對(duì)象，根據(jù)是否共患ADHD分為單純TD組（n=103）、TD+ADHD組（n=58），比較兩組患兒維生素D含量差異情況。結(jié)果 不同性別TD兒童25（OH）D含量無(wú)顯著性差異（P＞0.05）；病程＞12個(gè)月的TD兒童25（OH）D含量低于病程≤12個(gè)月的TD兒童，差異具有統(tǒng)計(jì)學(xué)意義（t=3.02，P＜0.05）；病程＞12個(gè)月組TD兒童血清25（OH）D不足比例高于病程≤12個(gè)月組，差異有統(tǒng)計(jì)學(xué)意義（χ2=6.88，P＜0.05）；中重度TD兒童的25（OH）D含量明顯低于輕度TD兒童（t=3.64，P＜0.05）；中重度TD組兒童血清25（OH）D不足及缺乏比例明顯高于輕度TD組，差異有統(tǒng)計(jì)學(xué)意義（χ2=18.23，P＜0.05）；TD+ADHD兒童與單純TD兒童的25（OH）D含量差異無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）；TD+ADHD組兒童血清25（OH）D不足及缺乏比例高于單純TD組，差異有統(tǒng)計(jì)學(xué)意義（χ2=3.85，P＜0.01）。結(jié)論 維生素D缺乏程度與TD的病情、病程及合并ADHD的風(fēng)險(xiǎn)呈正相關(guān)性。

［關(guān)鍵詞］抽動(dòng)障礙；注意缺陷多動(dòng)障礙；維生素D；兒童

Doi：10.3969/j.issn.1673-5293.2024.09.011

［中圖分類(lèi)號(hào)］R179""" ［文獻(xiàn)標(biāo)識(shí)碼］A

［文章編號(hào)］1673-5293（2024）09-0071-05

Study on differences in vitamin D levels in children with tics and

comorbid attention deficit hyperactivity disorder

［Abstract］ Objective To investigate the relationship between serum vitamin D levels and the onset of tic disorder （TD） and comorbid attention deficit hyperactivity disorder （ADHD）. Methods A total of 161 children diagnosed with TD at the pediatric outpatient department of Panzhihua Central Hospital from April 2021 to April 2023 were selected as study subjects.According to whether they had comorbid ADHD，they were divided into the simple TD group （n=103） and the TD+ADHD group （n=58）.The differences in vitamin D levels between the two groups were compared. Results There was no significant difference in 25（OH）D levels between TD children of different genders （P＞0.05）.TD children with a disease course of ＞ 12 months had lower 25（OH）D levels than those with a disease course of ≤ 12 months，with a statistically significant difference （t=3.02，P＜0.05）.The proportion of TD children with insufficient serum 25（OH）D levels in the ＞ 12 months group was higher than that in the ≤ 12 months group，with a statistically significant difference （χ2=6.88，P＜0.05）.The 25（OH）D levels in children with moderate to severe TD were significantly lower than those in children with mild TD （t=3.64，P＜0.05）.The proportion of children with insufficient and deficient serum 25（OH）D in the moderate to severe TD group was significantly higher than that in the mild TD group，with a statistically significant difference （χ2=18.23，P＜0.05）.There was no statistically significant difference in 25（OH）D levels between children with TD+ADHD and those with simple TD （P＞0.05）.The proportion of children with insufficient and deficient serum 25（OH）D levels in the TD+ADHD group was higher than that in the simple TD group，with a statistically significant difference （χ2=3.85，P＜0.01）. Conclusion The degree of vitamin D deficiency is positively correlated with the severity，disease course，and risk of comorbid ADHD in TD.

［Key words］ tic disorder;attention deficit hyperactivity disorder;vitamin D;children

抽動(dòng)障礙（tic disorders，TD）是一種多發(fā)于兒童或青少年時(shí)期的神經(jīng)精神障礙性疾病，主要表現(xiàn)為突然的、快速的、反復(fù)出現(xiàn)的、無(wú)節(jié)律的運(yùn)動(dòng)或/和發(fā)聲抽動(dòng)，患病率約為1%［1］。TD的病因尚不清楚，可能是遺傳、神經(jīng)生理、神經(jīng)生化和環(huán)境因素相互作用的結(jié)果［2-3］。TD的常見(jiàn)共患病包括注意缺陷多動(dòng)障礙（attention deficit hyperactivity disorder，ADHD）、焦慮癥和強(qiáng)迫癥等。ADHD指發(fā)生于兒童時(shí)期，與同齡兒童相比，以明顯注意集中困難、注意持續(xù)時(shí)間短暫、活動(dòng)過(guò)度或沖動(dòng)為主要特征的一組綜合征。Marwitz等［4］對(duì)TD患兒的合并癥發(fā)生率進(jìn)行評(píng)估，結(jié)果顯示ADHD發(fā)生率最高，為37%。……