目的:调查儿童抽动障碍发病情况,对其进行研究,了解抽动障碍发病特点及其相关危险因素,为制定预防措施提供来源依据。方法:选取2013年1月至2013年12月上海新华医院中医科就诊的抽动障碍儿童122例,发放问卷调查患儿的一般资料、家族史、既往史、母孕史、发病情况包括发病年龄、就诊年龄、病程进行分析。结果:122例患儿中发病年龄大多集中在10岁以前,为总发病儿童的93.4%,4-6岁的占45.9%,7-9岁的占39.3%。就诊年龄中〈6岁的占27.9%,6-8岁占39.3%,9-11岁占24.6%。病程〈6月的占13.1%,6-12月的占27.9%,1-2年的占19.7%,≥2年的占39.3%。其中36.1%有反复呼吸道感染史(OR〉1,P〈0.05);29.5%在生产中有轻度窒息(OR〉1,P〈0.05);11.5%有流产史(OR〉1,P〉0.05);13.1%有家族抽动障碍史(OR〉1,P<0.05);其中反复呼吸道感染、生产中轻度窒息、家族抽动障碍史是抽动障碍发病的危险因素。结论:儿童抽动障碍发病年龄较早,其起病可能是由多因素相互作用的结果,其中反复呼吸道感染、生产中轻度窒息、家族抽动障碍史是抽动障碍发病的危险因素。
Objective: To investigate the morbidity situation and risk factors of tic disorders in children, and provide the basis for disease prevention. Methods: From January 2013 to December 2013, 122 children with tic disorders were enrolled from the TCM department of Shanghai Xinhua hospital. All cases were surveyed by a questionnaire, and the general information, family history, previous medical history, history of maternal pregnancy, and morbidity information, including the onset age, age of initial attendance, course of disease were collected and analyzed. Results: Data of the 122 cases suggested that onset age of tic disorders in most cases were below 10 years old (93.4% of the total incidence), specifically, 45.9% of them were between 4 and 6 years old, 39.3% were between 7 and 9 years old. The initial attendance age of 27.9% children were below 6 months, 39.3% were between 6 and 8 months, 24.6% were between 9 and 11 months. Disease course of 13.1% children were less than 6 months, 27.9% were between 6 and 12 months, 19.7% were between 1 and 2 years, 39.3% were more than or equal to 2 years. 36.1% of the cases had a history of recurrent respiratory tract infections, and 36.1% had mild anoxia neonatorum, mothers of 11.5% of them had a history of miscarriage, 13.1% had the family history of tic disorders. Among these, the respiratory infections, anoxia neonatorum and family history were the risk factors of tic disorders (OR〉1, P〈0.05). Conclusions: The tic disorders may occur at the very early age of the children, so the early detection and treatment are helpful. Pathogenesis of tic disorders are complex, and the respiratory infections, anoxia neonatorum and family history are the risk factors of tic disorders.