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儿童过敏性鼻炎治疗后,注意缺陷多动障碍相关症状有所改善。

Attention-deficit/hyperactivity disorder-related symptoms improved with allergic rhinitis treatment in children.

作者信息

Yang Ming-Tao, Chen Chia-Chun, Lee Wang-Tso, Liang Jao-Shwann, Fu Wen-Mei, Yang Yao-Hsu

机构信息

Department of Pediatrics, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

出版信息

Am J Rhinol Allergy. 2016 May;30(3):209-14. doi: 10.2500/ajra.2016.30.4301.

Abstract

BACKGROUND

Increased prevalence of attention-deficit/hyperactivity disorder (ADHD) in children with allergic rhinitis (AR) has been reported. Our previous study showed that children with untreated AR had higher ADHD scores than did the controls.

OBJECTIVE

This prospective follow-up study aimed to investigate whether elevated ADHD scores in children with AR could be decreased by AR treatment.

METHODS

Sixty-eight children with AR (age range, 6-14 years) and who were drug naive were enrolled and evaluated by AR symptom score, ADHD symptom scores, and computerized continuous performance test, before and after AR therapy, which included nonpharmacologic intervention, oral antihistamines, and topical steroids. Thirty-one age-matched controls and 13 children with pure ADHD were also enrolled for comparison. The relationship between the AR and ADHD score change was analyzed by a partial correlation test, and univariate and multivariate linear regression models were applied to investigate possible predictors for the improvement of ADHD scores by AR treatment.

RESULTS

AR symptom scores in children with AR decreased significantly after treatment (p < 0.001), and their ADHD scores also decreased significantly (p < 0.001). An improved AR symptom score was positively correlated with improved detectability (rp = 0.617, p = 0.001) and commission error (rp = 0.511, p = 0.011). Significant predictors for the improvement of ADHD scores included age, AR drugs, AR subtypes, and multiple atopic diseases (ps < 0.05).

CONCLUSION

Higher ADHD scores in children with AR compared with healthy controls decreased significantly with AR treatment. For children with AR and borderline ADHD symptoms, who do not meet full ADHD diagnostic criteria, we recommend initially treating their AR and monitoring improvement of ADHD symptoms.

摘要

背景

有报道称过敏性鼻炎(AR)患儿中注意力缺陷多动障碍(ADHD)的患病率有所增加。我们之前的研究表明,未经治疗的AR患儿的ADHD评分高于对照组。

目的

这项前瞻性随访研究旨在调查AR治疗是否能降低AR患儿升高的ADHD评分。

方法

纳入68例年龄在6至14岁之间、未使用过药物的AR患儿,在AR治疗前后通过AR症状评分、ADHD症状评分和计算机化连续性能测试进行评估,治疗包括非药物干预、口服抗组胺药和局部用类固醇。还纳入了31例年龄匹配的对照组和13例单纯ADHD患儿进行比较。通过偏相关检验分析AR与ADHD评分变化之间的关系,并应用单变量和多变量线性回归模型研究AR治疗改善ADHD评分的可能预测因素。

结果

AR患儿治疗后的AR症状评分显著降低(p < 0.001),其ADHD评分也显著降低(p < 0.001)。AR症状评分的改善与检测能力的提高(rp = 0.61×7,p = 0.001)和执行错误(rp = 0.51×1,p = 0.011)呈正相关。ADHD评分改善的显著预测因素包括年龄、AR药物、AR亚型和多种特应性疾病(ps < 0.05)。

结论

与健康对照组相比,AR患儿较高的ADHD评分经AR治疗后显著降低。对于有AR且有边缘性ADHD症状但不符合ADHD完整诊断标准的患儿,我们建议首先治疗其AR并监测ADHD症状的改善情况。

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