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[特定生物元素缺乏对某些特定精神障碍儿童多动症状的影响]

[The effect of deficiency of selected bioelements on hyperactivity in children with certain specified mental disorders].

作者信息

Starobrat-Hermelin B

机构信息

Oddziału Psychiatrii Dzieci, Dzieckiem i Młodzieza w Szczecinie.

出版信息

Ann Acad Med Stetin. 1998;44:297-314.

PMID:9857546
Abstract

The aim of my work was the answer to the following questions: how often does the deficiency of magnesium, copper, zinc, calcium, iron occur among hyperactive children in comparison with healthy children, deficiency of which of the considered bioelements is the most frequent, what is the effect of supplementation of deficit element on hyperactivity and does it depend on other certain disorders that coexist with hyperactivity? In a process of establishing the subject diagnosis I have followed the DSM IV criteria recognizing ADHD among examined ones. I have determined the deficiency of magnesium, copper, zinc, calcium, iron in the group of 116 children with diagnosed ADHD. Consequently, as a result, I have found out that shortage of above-mentioned bioelements occurs more often among hyperactive children than among those being healthy, and deficiency of magnesium is the most frequent in this respect. Further, I have divided the group of 110 children with magnesium deficiency into two groups according to the other mental disorders that coexist with ADHD: 1) the group where hyperactivity coexists with disorders typical for developmental age such as enuresis, tics, separation anxiety, stuttering, selective mutism (63 children); 2) the group where hyperactivity coexists with disruptive behaviour disorders: conduct disorder and oppositional defiant disorder (47 children). The content of magnesium, copper, zinc, calcium, iron has been determined respectively in blood (serum and red cells) and in hair by atomic absorption spectroscopy method in both groups accordingly. At the same time, the hyperactivity tests were carried out using Conner's Rating Scales for Parents and Teachers, Wender's Scale as well as Quotient of Development to Freedom from Distractibility. During the statistical analysis the inparametric tests have been used taking as a significance level p < 0.05. On the ground of obtained findings I have not stated any significant differences in bioelements content among hyperactive children in relation to other coexisting disorders, except for zinc. The zinc content in hair was higher among children with ADHD and disruptive behaviour disorder. The assessment of hyperactivity indicated the remarkably higher coefficient among children with coexisting behaviour disorders as compared to hyperactive children among whom, additionally, disorders typical for developmental age have occurred. The analysis of influence exerted by magnesium supplementation on hyperactivity has been carried out in the group of total 75 children with ADHD jointly with magnesium deficiency. The group of 50 children actually tested, apart from standard treatment have received the specified doses of magnesium preparations for 6 months on regular basis. The group of 25 children was left with standard treatment without additional magnesium. In both above-mentioned groups the content of bioelements and respectively ADHD level have been determined just before and after the test. The obtained results have clearly disclosed significant increase of magnesium, zinc, calcium content (Tab. 1) and respectively essential decrease of hyperactivity in the group of children treated with magnesium. At the same time, however, among the children given standard treatment without magnesium, hyperactivity has intensified (Tab. 3, 4). The findings herein presented indicate that it is necessary to take into consideration a possible bioelements deficiency among children with ADHD. Consequently, the accomplished study proves that there is a need of magnesium supplementation in ADHD children irrespectively of other mental disorders. The supplementation of that kind of magnesium supplementation together with standard traditional mode of treatment gives us the opportunity to extend the methods of therapy of ADHD children who are the "children of the risk" in connection with their educational, emotional and social problems.

摘要

我的工作目的是回答以下问题

与健康儿童相比,多动症儿童中镁、铜、锌、钙、铁缺乏的情况有多常见,所考虑的这些生物元素中哪种缺乏最为频繁,补充缺乏的元素对多动症有何影响,以及这是否取决于与多动症共存的其他特定病症?在确立主题诊断的过程中,我遵循了DSM-IV标准来认定受检儿童中的注意力缺陷多动障碍(ADHD)。我测定了116名被诊断为ADHD的儿童体内镁、铜、锌、钙、铁的缺乏情况。结果,我发现上述生物元素的缺乏在多动症儿童中比在健康儿童中更常见,其中镁缺乏在这方面最为频繁。此外,我根据与ADHD共存的其他精神障碍,将110名镁缺乏儿童分为两组:1)多动症与发育年龄典型病症如遗尿症、抽搐、分离焦虑、口吃、选择性缄默症共存的组(63名儿童);2)多动症与破坏性行为障碍(品行障碍和对立违抗障碍)共存的组(47名儿童)。相应地,通过原子吸收光谱法分别测定了两组儿童血液(血清和红细胞)及头发中镁、铜、锌、钙、铁的含量。同时,使用父母和教师的康纳氏评定量表、温德量表以及注意力分散自由度发育商数进行了多动症测试。在统计分析中,采用非参数检验,显著性水平为p < 0.05。基于所得结果,除了锌之外,我未发现多动症儿童体内生物元素含量与其他共存病症之间存在任何显著差异。患有ADHD和破坏性行为障碍的儿童头发中的锌含量较高。多动症评估表明,与还患有发育年龄典型病症的多动症儿童相比,患有共存行为障碍的儿童的系数显著更高。在总共75名患有ADHD且伴有镁缺乏的儿童组中,进行了镁补充对多动症影响的分析。实际测试的50名儿童除了接受标准治疗外,还定期接受规定剂量的镁制剂,为期6个月。25名儿童仅接受标准治疗,未额外补充镁。在上述两组中,分别在测试前后测定了生物元素含量和ADHD水平。所得结果清楚地表明,接受镁治疗的儿童组中镁、锌、钙含量显著增加(表1),多动症相应地显著降低。然而,同时,仅接受标准治疗而未补充镁的儿童中,多动症有所加剧(表3、4)。本文呈现的研究结果表明,有必要考虑多动症儿童可能存在的生物元素缺乏情况。因此,已完成的研究证明,无论其他精神障碍如何,ADHD儿童都需要补充镁。这种镁补充与标准传统治疗方式相结合,使我们有机会扩展对ADHD儿童的治疗方法,这些儿童因其教育、情感和社会问题而属于“风险儿童”。

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