小学生注意缺陷多动障碍的危险因素分析
Analysis of risk factors for attention deficit/hyperactivity disorder in pupils

目的·探索小学不同阶段注意缺陷多动障碍（ADHD）患病率的分布情况，并分析学龄儿童患病的危险因素。方法·采用分级整群抽样的方法在上海、广州、西安等9个城市进行家长问卷调查儿童ADHD诊断史及一般情况。将小学6个年级分为3个年级阶段：1～2年级、3～4年级、5～6年级。统计3个年级阶段ADHD患病率、ADHD与非ADHD儿童自感学业压力比例及不同年龄入学儿童ADHD患病率差异，建立Logistic回归模型分析ADHD患病的危险因素。结果·不同年级阶段儿童ADHD患病率差异有统计学意义（P<0.05），其中3～4年级阶段儿童ADHD患病率最高，为5.2%。在调整了儿童性别、父母亲教育程度、分娩方式等因素后，3～4年级阶段、儿童提前入学、儿童读书自感压力是ADHD患病的危险因素（均P<0.05）。结论·3～4年级阶段、提前入学（<6岁）、读书自感压力的儿童患ADHD的风险增加。
： Objective · To explore the prevalence of attention-deficit/hyperactivity disorder (ADHD) in different grades of pupils and analyze the risk factors for ADHD in school-aged children. Methods · The diagnosis history of ADHD and general information of children in nine cities such as Shanghai, Guangzhou, Xi’an, etc. were collected from their parents by questionnaires with the use of cluster-stratified method. Six grades in primary schools were assigned to 3 groups, i.e. the grade 1 and 2 group, grade 3 and 4 group, and grade 5 and 6 group. Prevalence of ADHD in 3 groups and differences in study pressure between children with and without ADHD and in prevalence of ADHD between children with different enrollment ages were calculated. Risk factors related to the prevalence of ADHD were analyzed by Logistic regression model. Results · The difference in the prevalence of ADHD between three groups were statistically significant (P<0.05). The prevalence of ADHD in the grade 3 and 4 group was the highest (5.2%). Grade 3 and 4, earlier school enrollment, and study pressure were risk factors for the prevalence of ADHD after adjustment of sex, education of parents, delivery method, etc. Conclusion · Grade 3 and 4, earlier school enrollment (<6 years of age), and study pressure increase the risk of ADH in pupils