目的 评估Duchenne型肌营养不良(DMD)患儿合并注意缺陷多动障碍(ADHD)的共患率,分析相关影响因素及ADHD对DMD患儿生存质量的影响.方法 选取2017年3—10月在武警总医院DMD多学科联合门诊就诊,经基因检测及临床表现确诊为DMD患儿102例.采用美国《精神障碍诊断与统计手册》第4版(DSM-Ⅳ)标准评定DMD患儿是否合并ADHD.采用中文版PedsQLTM3.0神经肌肉疾病模块(PedsQLTM3.0 NMM)和PedsQLTM4.0普适性核心量表对5~7岁的DMD患儿进行生存质量调查.结果 DMD患儿合并ADHD共患率为34.31%(35/102),其中注意缺陷型14例(40.0%),多动/冲动型10例(28.6%),混合型11例 (31.4%).多因素Logistic回归分析结果显示,年龄、主要看护者为祖父母是DMD患儿共患ADHD的影响因素(P<0.05).ADHD组患儿角色功能、心理功能评分均低于无ADHD组(P<0.05).结论 ADHD在DMD患儿中患病率高,年龄和家庭环境因素对共患ADHD有影响,共患ADHD的患儿生存质量较差.%Objective To assess the co-morbidity rate of children with Duchenne muscular dystrophy (DMD) and attention deficit hyperactivity disorder (ADHD),and to analyze the factors which impact DMD and the effects of ADHD on quality of life in children.Methods A total of 102 children diagnosed with DMD between March and October 2017 were enrolled in the study.The Diagnostic and Statistical Manual of Mental Disorders Ⅳ (DSM-Ⅳ) was used to evaluate the prevalence of ADHD in children with DMD.We used the Pediatric Quality of Life InventoryTM3.0 Neuromuscular Module(PedsQLTM3.0 NMM) and PedsQLTM4.0 scale to determine the quality of life in children with DMD (age range,5-7 years).Results The co-morbidity rate of children with DMD and ADHD was 34.31% (35/102).There were 14 children(40.0%) with attention deficit disorder ,10 children(28.6%) with hyperactivity disorder ,and 11 children (31.4%) with a combination of the disorders.The results of multivariate Logistic regression analysis showed that the factors impacting children with DMD and ADHD were age and grandparents as main caregivers(P<0.05).The scores of physical and psychological function in the ADHD group were significantly lower than the non-ADHD group (P<0.05).Conclusion ADHD has a high prevalence in children with DMD.The children with DMD and ADHD were affected by age and family environment,and the children always had a relatively poor quality of life.
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