儿童感觉统合失调的巢式病例对照研究

目的 探讨影响儿童感觉统合失调(SID)6年前后发病与转归的可疑危险因素和可能的保护因素。方法 采用儿童生活环境调查表和感觉统合诊断表对北京市城区310名儿童进行6年的追踪调查,进行配比的巢式病例对照研究,以单因素及多因素条件logistic回归分析资料。结果 与儿童SID发生有关联的主要可疑危险因素为妊娠水肿(OR＝7．06)、母亲骨盆狭窄(OR＝3．45)、家族可疑多动倾向(OR＝3．02),其次为父亲年龄偏大(OR＝1．28)、婴幼儿期疾病(OR＝1．13)、社会风气差(OR＝1．69)、父母管教不一致(OR＝1．45)、学龄期听音乐、故事及看电影电视少(OR＝1．98)、父亲职业(OR＝1．19)。SID的保护因素有家庭支持系统好(OR＝0．54)、居住玩乐环境好(OR＝0．37)、父母对孩子的投入多(OR＝0．51)、幼儿期母亲文化程度高(OR＝0．38)。结论 儿童SID主要与生物学及遗传等危险因素有关,其次为家庭生活环境等社会心理因素。

A nested case-control study on child sensory integrative dysfunction

Objective To explore risk factors and protective factors of sensory integrative dysfunction (SID) among preschool and school children in Beijing, and to identify potential risk factors of SID. Methods Three hundred and ten kindergarten children were investigated twice in 1993 and 1999 by "The Child Sensory Integration Check List" and "General Information Questionnaire". A nested case-control study was carried out by single variable and multivariate conditional logistic regression analysis to find out the risk factors of SID. Results In the SID incidence group, the risk factors of SID were edema during pregnancy ( OR = 7.06 ), paternal age ( OR = 1.28 ), suffering from diseases before 3 years old ( OR = 1.13 ), while the protective factor was family support network during school age ( OR = 0.54 ). In the SID self-recovery group, the risk factors of SID were suspected attention-deficit hyperactivity disorder (ADHD) among maternal cousins ( OR = 3.02 ), social ethos ( OR = 1.69 ), consistency of parental discipline ( OR = 1.45 ), while the protective factors were living condition and environment for entertainment ( OR = 0.37 ), parental care during school age. In the SID negative group, the risk factors of SID were maternal contracted pelvis ( OR = 3.45 ),less chance in enjoying audio and video entertainment during school age ( OR = 1.98 ), suspected ADHD among paternal cousins ( OR = 1.89 ), consistency of parental discipline ( OR = 1.75 ), suspected ADHD among maternal cousins ( OR = 1.48 ), paternal occupation during school age ( OR = 1.19 ), while the protective factors were family support network ( OR = 0.56 ) and maternal educational background ( OR = 0.38 ) during preschool age. Conclusion Our data showed that the risk factors of child SID were mainly associated with biological and genetic factors. Psychosocial factors seemed to be the secondary risk factors of SID.