Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden.
J Pediatr Surg. 2019 Oct;54(10):2024-2027. doi: 10.1016/j.jpedsurg.2018.10.067. Epub 2018 Nov 7.
Hirschsprung disease (HSCR) has previously been associated with increased need of special education services despite normal intelligence. The aim of this study was to assess the risk of attention deficit hyperactivity disorders (ADHD) in individuals with HSCR in a population-based cohort.
This was a nationwide, population-based cohort study. The study exposure was HSCR and the study outcome was ADHD. The cohort included all individuals with HSCR registered in the Swedish National Patient Register between 1964 and 2013 and ten age- and sex-matched controls per patient, randomly selected from the Population Register.
The cohort comprised 739 individuals with HSCR and 7390 controls. Twenty-six of the 739 individuals with HSCR and 202 of the 7390 controls were diagnosed with ADHD, Odds ratio (OR) 1.30, Confidence interval (CI) 95% 0.84-1.93, indicating no difference in risk for ADHD. The mean age at diagnosis of ADHD was not different between the groups; 18.1 years (SD 8.4) vs 16.7 years (SD 7.8), p = 0.39. Down syndrome did not affect the risk for ADHD, OR 2.26 (CI 95% 0.68-5.53). Female gender decreased the risk for ADHD, OR 0.58 (CI 95% 0.40-0.83).
There is no increased risk of ADHD in patients with Hirschsprung disease.
Prognosis study, level of evidence: Level I.
先天性巨结肠（HSCR）既往与特殊教育服务需求增加有关，尽管患者智力正常。本研究旨在评估人群中 HSCR 个体发生注意缺陷多动障碍（ADHD）的风险。
这是一项全国性的基于人群的队列研究。研究暴露为 HSCR，研究结局为 ADHD。该队列纳入了 1964 年至 2013 年间在瑞典国家患者登记处登记的所有 HSCR 患者，每位患者匹配 10 名年龄和性别相匹配的对照者，从人口登记处随机选择。
该队列包括 739 名 HSCR 患者和 7390 名对照者。739 名 HSCR 患者中有 26 名和 7390 名对照者中有 202 名被诊断为 ADHD，比值比（OR）为 1.30，95%置信区间（CI）为 0.84-1.93，表明 ADHD 的发病风险无差异。两组 ADHD 的诊断年龄均无差异，分别为 18.1 岁（SD 8.4）和 16.7 岁（SD 7.8），p=0.39。唐氏综合征并不影响 ADHD 的发病风险，OR 为 2.26（95%CI 0.68-5.53）。女性降低了 ADHD 的发病风险，OR 为 0.58（95%CI 0.40-0.83）。
HSCR 患者发生 ADHD 的风险没有增加。
预后研究，证据等级：I 级。
