Yang Ming-Tao, Lee Wang-Tso, Liang Jao-Shwann, Lin Yu-Ju, Fu Wen-Mei, Chen Chia-Chun
Department of Pediatrics, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Pediatr Neonatol. 2014 Jun;55(3):168-74. doi: 10.1016/j.pedneo.2013.09.003. Epub 2013 Nov 7.
Allergic rhinitis (AR) is the most common chronic allergic disease in school-age children. An increased prevalence of attention deficit hyperactivity disorder (ADHD) in AR patients has been reported; however, inattention and hyperactivity in AR children have not been investigated using objective and scientific measurements.
We used AR symptom score, ADHD symptom scale, and computerized continuous performance test (CPT) to study the attention and impulsivity in AR children, age-matched controls, and ADHD children (aged 6-15 years). Univariate and multivariate linear regression analyses were applied to identify risk factors for impulsivity and inattention in AR children.
Twenty-nine controls, 10 ADHD, and 105 AR children were enrolled. There were no differences in age and sex among the three groups. The scores of Hyperactivity/Impulsivity subscales of ADHD symptoms from both parents and teachers were significantly higher in the AR children. The CPT in AR children revealed higher commission errors, shorter reaction times, and more perseveration. Risk factors for inattention and impulsivity in AR children included younger age, male sex, higher AR symptom scores, persistent AR, moderate/severe AR, multiple atopic diseases, family history of atopy, and possible comorbidity with ADHD.
Care for AR children should not only involve treating their allergy, but also monitoring the possible comorbidities of impulsivity and inattention. In children with impulsivity, AR should be considered in addition to ADHD.
过敏性鼻炎(AR)是学龄儿童中最常见的慢性过敏性疾病。有报道称AR患者中注意力缺陷多动障碍(ADHD)的患病率增加;然而,尚未使用客观和科学的测量方法对AR儿童的注意力不集中和多动情况进行研究。
我们使用AR症状评分、ADHD症状量表和计算机化连续性能测试(CPT)来研究AR儿童、年龄匹配的对照组儿童以及ADHD儿童(6至15岁)的注意力和冲动性。应用单变量和多变量线性回归分析来确定AR儿童冲动性和注意力不集中的危险因素。
共纳入29名对照组儿童、10名ADHD儿童和105名AR儿童。三组儿童在年龄和性别上无差异。AR儿童父母和教师评定的ADHD症状多动/冲动分量表得分均显著更高。AR儿童的CPT显示错误率更高、反应时间更短且持续性更强。AR儿童注意力不集中和冲动性的危险因素包括年龄较小、男性、AR症状评分较高、持续性AR、中度/重度AR、多种特应性疾病、特应性家族史以及可能合并ADHD。
对AR儿童的护理不仅应包括治疗其过敏,还应监测可能合并的冲动性和注意力不集中情况。对于有冲动性的儿童,除了ADHD外还应考虑AR。