【作者】 张晓宇；

【导师】 陈虹；

【作者基本信息】 大连医科大学 ， 儿科学， 2008， 硕士

【摘要】 目的:通过本研究,了解我国注意缺陷多动障碍(ADHD)儿童体内脂肪酸、镁、锌、硒含量的变化情况。同时了解脂肪酸与镁、锌、硒、行为、智力间的相关性。方法:对35例注意缺陷多动障碍(ADHD)儿童及25例正常儿童进行血浆脂肪酸,血清镁、锌、硒含量测定。选用Achenbach儿童行为量表(CBCL)及瑞文测验对两组儿童进行行为及智力评定。结果:①两组在亚油酸(18:2)、DHA(22:6)两种脂肪酸含量上的差异均有统计学意义。亚油酸:ADHD组(31.35±3.43),对照组(29.31±3.31),P=0.025;DHA:ADHD组(3.06±0.97),对照组(3.75±1.30),P=0.022。在16:0、18:0、18:1、20:2、20:4五种脂肪酸含量上的差异均无统计学意义。②两组在镁、硒两种元素含量上的差异均有统计学意义。镁元素:ADHD组(0.84±0.05),对照组(0.87±0.06),P=0.013;硒元素:ADHD组(87.91±10.71),对照组(97.12±7.63),P=0.001。在锌元素含量上的差异无统计学意义。③两组在CBCL活动情况及躯体主诉两方面的差异均无统计学意义。其余各方面的差异均有统计学意义:社会能力部分,ADHD组得分均低于对照组;行为问题部分,ADHD组得分均高于对照组。④两组智力方面的差异有统计学意义:ADHD组智商(IQ)低于对照组。⑤16:0、20:4两种脂肪酸与镁、锌、硒、行为、智力间的相关性均无统计学意义。其余五种脂肪酸与这些内容的相关性均有统计学意义:18:0与躯体主诉呈负相关;18:1与退缩呈负相关;18:2与锌、硒元素、学校情况、社会能力总分呈负相关,与退缩、焦虑/抑郁、社交问题、注意问题、违纪行为、攻击性行为、内向性行为问题、外向性行为问题、行为问题总分呈正相关;20:2与硒元素呈正相关; 22:6与学校情况、智商(IQ)呈正相关,与社交问题、注意问题、攻击性行为、外向性行为问题、行为问题总分呈负相关。⑥将镁、锌、硒元素、脂肪酸16:0、18:0、18:1、18:2、20:2、20:4、22:6作为自变量,将组别(ADHD组、对照组)作为因变量引入Logistic回归模型,最后镁、硒、16:0、22:6进入方程。结论:①ADHD组儿童较对照组儿童有明显高的血浆亚油酸(18:2,ω-6)水平及明显低的血浆DHA(22:6,ω-3)水平。②ADHD组儿童较对照组儿童有明显低的血清镁元素含量及血清硒元素含量。③在镁、锌、硒元素、脂肪酸16:0、18:0、18:1、18:2、20:2、20:4、22:6十种因素与儿童ADHD发生关系的研究中,镁、硒、16:0、22:6对ADHD发生的影响较大。镁、硒含量增加,患ADHD的可能性减少。当16:0与22:6在人体内满足一定比例时,它们含量增加,会减少患ADHD的可能性。④血浆脂肪酸尤其亚油酸(18:2,ω-6)、DHA(22:6,ω-3)与锌、硒、行为、智力间存在一定关联。更多还原

【Abstract】 Objectives: To evaluate the status of fatty acids, magnesium, zinc and selenium in Chinese children with attention-deficit hyperactivity disorder (ADHD). To find out the correlations between magnesium, zinc, selenium, behavior, intelligence and fatty acids.Methods: This study measured the content of plasma fatty acids and serum magnesium, zinc, selenium in 35 ADHD children and 25 control children. The two groups of children were assessed the condition of behavior and intelligence through Child Behavior Checklist (CBCL) and Combined Raven,s Test (CRT).Results:①There were significant differences of the levels about linoleic acid (18:2) and DHA (22:6) in the two groups of children except the fatty acids about 16:0, 18:0, 18:1, 20:2 and 20:4. Linoleic acid: ADHD group (31.35±3.43), control group (29.31±3.31), P=0.025; DHA: ADHD group (3.06±0.97), control group (3.75±1.30), P=0.022.②There were significant differences of the concentrations about magnesium and selenium in the two groups of children except zinc. Magnesium: ADHD group (0.84±0.05), control group (0.87±0.06), P=0.013; selenium: ADHD group (87.91±10.71), control group (97.12±7.63), P=0.001.③There were significant differences about social competence and behavior problems of CBCL in the two groups of children except activity status and somatic complaint. ADHD children had lower social competence and more behavior problems than control children.④There was significant difference about intelligence in the two groups of children. ADHD children had lower intelligence than control children.⑤Significant correlations were observed between magnesium, selenium, zinc, behavior, intelligence and fatty acids except 16:0, 20:4. Inverse correlations: 18:0 and somatic complaint; 18:1 and withdrawal; 18:2 and zinc, selenium, school status, total social competence; 22:6 and social interaction, attention, aggression, extroversion, total behavior problem. Consistent correlation: 18:2 and withdrawal, anxiety/depression, social interaction, attention, delinquency, aggression, introversion, extroversion, total behavior problem; 20:2 and selenium; 22:6 and school status, intelligence quotient (IQ).⑥Logistic regression model was established by the dependent variable of group and the covariates variables of magnesium, zinc, selenium, 16:0, 18:0, 18:1, 18:2, 20:2, 20:4, 22:6. Finally variables in the equation were magnesium, selenium, 16:0 and 22:6.Conclusions:①ADHD children had the significant higher lever of plasma linoleic acid (18:2,ω-6) and the significant lower lever of plasma DHA (22:6,ω-3) versus controls.②ADHD children had the significant lower concentrations of serum magnesium and selenium versus controls.③Magnesium, selenium, 16:0, 22:6 influenced ADHD greater than zinc, 18:0, 18:1, 18:2, 20:2, 20:4. The possibility of suffering from ADHD was decreased, when the content was increased about magnesium, selenium, as well as 16:0 and 22:6, which perhaps met a proper ratio in human body.④Plasma fatty acids had certain correlations with zinc, selenium, behavior and intelligence, especially linoleic acid (18:2,ω-6) and DHA (22:6,ω-3).更多还原