6~11岁不同亚型注意缺陷多动障碍儿童行为问题分析

注意缺陷多动障碍(ADHD)是一种儿童常见的神经发育性障碍。由于 ADHD 女童及女性大多没有外化的行为问题，并且大众对于 ADHD 症状存在刻板印象，因此有相当一部分 ADHD 女童及女性未得到及时诊断和治疗，导致其多种社会功能受损，增加了成年期的健康隐患。2020 年英国ADHD 合作机构(The Uniled Kingdom ADHD Partnership)发表了“ADHD 女性患者：从全生命周期视角为识别和治疗患有注意缺陷/多动障碍的女童及女性提供指导的一份专家共识声明”，该共识首次提出从“全生命周期”的管理角度探讨 ADHD 女性患者的诊断和治疗方案并提供了相关建议。本文就该专家共识进行解读，以期为女童及女性 ADHD 的识别、评估诊断、治疗及管理等方面提供相关帮助，改善其长期健康状况和临床预后。

来源：中国当代儿科杂志

Cumulative exposure to multiple early life stressors is expected to affect behavioral development, causing increased susceptibility to neuropsychiatric disorders. The present study was designed to mimic such conditions in a rat model to study behavioral impairments during adolescence and adulthood. Female Wistar rats (n = 32; 140–150 gm) were switched to a low protein (LP; 8% protein) or control (20% protein) diet 15 days prior to conception, and then the diet regime was maintained throughout the experimental period. Pups born to control and LP dams were intraperitoneally injected with deltamethrin (DLT—pyrethroid insecticide; 0.7 mg/kg body weight; PND 1 to 7), lipopolysaccharide (LPS—bacterial endotoxin; 0.3 mg/kg body weight; PND 3 and 5), or DLT+LPS, on designated days forming eight experimental groups (Control, LP, Control+LPS, LP+LPS, Control+DLT, LP+DLT, Control+DLT+LPS and LP+DLT+LPS). Neurobehavioral assessments were performed in F1 rats (1, 3, 6 months) by open field, elevated plus maze, light and dark box, and rotarod tests. LP rats were found to be highly susceptible to either singular or cumulative exposure as compared to their age-matched control counterparts, showing significantly severe behavioral abnormalities, such as hyperactivity, attention deficits and low anxiety, the hallmark symptoms of neuropsychiatric disorders like schizophrenia and ADHD, suggesting thereby that early life multi-hit exposure may predispose individuals to developmental disorders.