摘要
目的观察注意缺陷多动障碍倾向(ADHD)幼儿下丘脑-垂体-肾上腺皮质轴(HPA)功能状态,探索该病的发病机制。方法以2013—2014年12月接受治疗的267例ADHD患儿为观察组,以同期接受体检的200例健康儿童为对照组,使用全自动发光免疫分析仪检测并比较两组儿童皮质醇、24h尿游离皮质醇(24h UFC)和促肾上腺皮质激素(ACTH)水平。结果观察组皮质醇、24h UFC和ACTH水平分别为(336.2±24.1)μg/L、(101.3±35.6)μmol/L和(26.3±11.3)pg/ml,对照组分别为(368.5±40.4)μg/L、(135.7±42.6)μmol/L和(27.1±12.4)p g/ml;观察组儿童皮质醇、24h UFC均低于对照组(均P<0.01)。注意缺陷为主型(ADHD-I)89例,冲动多动型为主型(ADHD-HI)85例,混合型(ADHD-C)93例,ADHD-HI组皮质醇水平明显低于ADHD-I组(P<0.05)。结论 ADHD患儿存在HPA调节功能障碍,低皮质醇水平可能与ADHD发生有关。
Objective To investigate the functional status of hypothalamic- pituitary- adrenal（HPA） axis in children with attention deficit hyperactivity disorder（ADHD）.Methods Total 267 children with ADHD（observation group） and 200 healthy children（control group） were enrolled in the study.Cortisol（CORT）,24 h urinary free CORT（24hUFC） and adrenocorticotropic hormone（ACTH） levels were measured by automated immunoassay analyzer.Results The CORT and 24 hUFC levels in observation group were significantly lower than those in controlgroup（336.2± 24.1μg/Lvs 368.5± 40.4μg/Land 101.3± 35.6μmol/L vs 135.7± 42.6μmol/L,P〈0.05）.There was no significant difference in ACTH levels between two groups（26.3± 11.3pg/mL vs27.1± 12.4pg/mL,P〉 0.05）.Among 267 ADHD children,there were 89 cases ofattention deficit- oriented type（ADHD- I）,85 cases of hyperactive impulsive type（ADHD- HI） and 93 cases of mixed type（ADHD- C）,the CORT levels in ADHD- HI cases was significantly lower than that in ADHD- Icases（P〈0.05）.Conclusion There is a regulating function obstacle of HPA in children with ADHD.The results indicate that low CORT level may closely related to the development of AHDH.
出处
《浙江医学》
CAS
2016年第13期1098-1100,共3页
Zhejiang Medical Journal
