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目的了解浙江省宁波市中学生注意缺陷多动障碍(ADHD)现状及其睡眠紊乱情况。方法于2015年5—6月采用分层随机整群抽样方法抽取宁波市中学生2 133人,采用自编一般情况调查表、中文版注意缺陷多动障碍评定量表-父母版(SNAP-IV)及失眠严重程度指数量表(ISI)对学生和家长进行现场问卷调查。结果ADHD症状评分正常组、临界组、中度异常组和重度异常组的比例分别为87.2%(1 861/2 133)、9.3%(199/2 133)、2.5%(54/2 133)和0.9%(19/2 133),男性高于女性(Z=5.68,P<0.01),低年级高于高年级(rs=-2.02,P<0.05);ADHD评分正常组、临界组、中度异常组和重度异常组失眠比例依次为20.63%(384/1 861)、31.66%(63/199)、37.04%(20/54)和42.11%(8/19),ADHD严重程度与失眠严重程度呈正相关(rs=4.36,P<0.01);各组上床、起床时间及睡眠时间差异均无统计学意义,ADHD症状临界组、中度异常组及重度异常组的ISI各单项评分及总分均高于正常组;注意缺陷评分、多动冲动评分及ADHD评分总分与ISI总分均呈正相关,以注意缺陷与ISI总分相关性最高。结论 ADHD症状高评分学生有较高的失眠发生率,提示对失眠症状的干预应作为ADHD的治疗目标之一。
Objective To understand the current status of ADHD and the disturbance of sleep in secondary school students in Ningbo City, Zhejiang Province. Methods A total of 2 133 middle school students were recruited by stratified random sampling method from May to June in 2015. A self-compiled questionnaire, Chinese version of attention deficit hyperactivity disorder assessment scale-Parents Version (SNAP-IV) And insomnia severity index (ISI) on-site questionnaires for students and parents. Results The rates of ADHD symptom score were 87.2% (1 861/2 133), 9.3% (199/2 133), 2.5% (54/2 133), respectively in the critical group, the critical group, the moderately abnormal group and the severe abnormal group 0.9% (19/2 133), male higher than female (Z = 5.68, P <0.01), lower grade higher than upper grade (rs = -2.02, P <0.05) The rates of insomnia in abnormal group and severe abnormal group were 20.63% (384/1 861), 31.66% (63/199), 37.04% (20/54) and 42.11% (8/19), respectively. The severity of ADHD and the severity of insomnia (Rs = 4.36, P <0.01). There was no significant difference in the time to get up, the time to get up and the sleep time in each group. The individual scores and total scores of ISI in the critical, moderate and severe abnormal ADHD groups Higher than the normal group; attention deficit score, hyperactivity impulsivity score and total score of ADHD score were positively correlated with ISI total score, and attention deficit had the highest correlation with ISI score. Conclusion High scores of ADHD symptoms have a higher incidence of insomnia, suggesting that the intervention of insomnia symptoms should be treated as one of the goals of ADHD.