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目的探讨注意缺陷多动障碍(ADHD)儿童的睡眠结构。方法2005-06—2006-04用多导睡眠监护仪(PSG)对首都儿科研究所神经内科就诊的41例ADHD患儿及30例正常儿童进行全夜睡眠结构检测。结果41例ADHD儿童中混合型(ADHD-C)24例、注意缺陷型(ADHD-I)11例、多动/冲动型(ADHD-H)6例。其中男35例,女6例(ADHD-I3、ADHD-C2、ADHD-H1例)。与对照组比较ADHD组REM潜伏期短、睡眠潜伏期延长、睡眠效率降低,差异有显著性(P<0·05);ADHD-C儿童睡眠Ⅱ期百分比较ADHD-I增加,差异有显著性(P<0·05);ADHD组睡眠周期性肢体运动(PLMS)发生率为41·5%,正常组PLMS发生率为13·33%,差异有显著性(P<0·05);ADHD组及正常对照组脑电图未见疒间性放电。结论(1)ADHD儿童存在REM睡眠结构的改变、入睡困难及睡眠效率降低;(2)PLMS也是导致ADHD儿童睡眠质量下降的原因之一;(3)ADHD儿童以男孩为主,女孩以注意力缺陷型为主。对学习困难的女孩应注意是否患有ADHD。
Objective To investigate the sleep structure of children with attention deficit hyperactivity disorder (ADHD). Methods From June 2005 to June 2005, 41 children with ADHD and 30 normal children undergoing neurosurgery in Capital Institute of Pediatrics underwent polysomnography (PSG). Results Among 41 children with ADHD, 24 were mixed (ADHD-C), 11 were ADHD-I and 6 were hyperactive / impulsive (ADHD-H). Including 35 males and 6 females (ADHD-I3, ADHD-C2, ADHD-H1 cases). Compared with the control group, ADHD group had shorter latent period of REM, longer sleep latency, lower sleep efficiency, the difference was significant (P <0.05); ADHD-C children’s sleep percentage increased more than ADHD-I, the difference was significant <0.05). The incidence of sleep-induced limb movement (PLMS) was 41.5% in ADHD group and 13.33% in normal group (P <0.05). The ADHD group and EEG normal control group no intercostal discharge. Conclusions (1) The changes of REM sleep structure, difficulty falling asleep and sleep efficiency in children with ADHD may be found. (2) PLMS is also one of the reasons leading to the decline of sleep quality in children with ADHD. (3) The children with ADHD are mainly boys and the girls with attention Defective based. For girls with learning difficulties should pay attention to whether they have ADHD.