| 摘要: |
| 目的 观察注意缺陷多动障碍倾向（ADHD）幼儿下丘脑 - 垂体 - 肾上腺皮质轴（HPA）功能状态，探索该病的发病机 制。 方法 以 2013—2014 年 12 月接受治疗的 267 例 ADHD 患儿为观察组，以同期接受体检的 200 例健康儿童为对照组，使用全 自动发光免疫分析仪检测并比较两组儿童皮质醇、24h 尿游离皮质醇（24hUFC）和促肾上腺皮质激素（ACTH）水平。 结果 观察组皮 质醇、24hUFC 和 ACTH 水平分别为（336.2±24.1）滋g/L、（101.3±35.6）滋mol/L 和（26.3±11.3）pg/ml，对照组分别为（368.5±40.4） 滋g/L、（135.7±42.6）滋mol/L 和（27.1±12.4）pg/ml；观察组儿童皮质醇、24hUFC 均低于对照组 （均 P＜0.01）。注意缺陷为主型 （ADHD-I）89 例，冲动多动型为主型（ADHD-HI）85 例，混合型（ADHD-C）93 例，ADHD-HI 组皮质醇水平明显低于 ADHD-I 组（P＜0.05）。 结论 ADHD 患儿存在 HPA 调节功能障碍，低皮质醇水平可能与 ADHD 发生有关。 |
| 关键词: 注意缺陷多动障碍倾向 下丘脑 - 垂体 - 肾上腺皮质轴 皮质醇 促肾上腺皮质激素 |
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| Functional status of hypothalamic-pituitary-adrenal axis in children with attention deficit hyperactivity disorder |
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LIU Cangbing
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Changxing county People's Hospital
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| Abstract: |
| Objective To investigate the functional status of hypothalamic-pituitary-adrenal (HPA) axis in children with attention deficit hyperactivity disorder (ADHD). Methods Total 267 children with ADHD (observation group) and 200 healthy children (control group) were enrolled in the study. Cortisol (CORT), 24h urinary free CORT (24hUFC) and adrenocorticotropic hormone (ACTH) levels were measured by automated immunoassay analyzer. Results The CORT and 24hUFC levels in observation group were significantly lower than those in control group (336.2±24.1滋g/L vs 368.5±40.4滋g/Land 101.3±35.6滋mol/L vs 135.7± 42.6滋mol/L, P＜0.05). There was no significant difference in ACTH levels between two groups (26.3±11.3pg/mL vs 27.1±12.4pg/mL, P ＞0.05).Among 267 ADHD children, there were 89 cases of attention deficit-oriented type(ADHD-I), 85 cases of hyperactive impulsive type (ADHD-HI) and 93 cases of mixed type (ADHD-C), the CORT levels in ADHD-HI cases was significantly lower than that in ADHD-I cases(P＜0.05). Conclusion There isa regulating function obstacle of HPA in children with ADHD. The results indicate that low CORT level may closely related to the development of AHDH. |
| Key words: Attention deficit hyperactivity disorder Hypothalamic-pituitary-adrenal Cortisol Adrenocorticotropic hormone |
