国内儿童注意缺陷多动障碍与血铅水平关系的Meta分析

摘要

Objective: To study the domestic ADHD (attention deifcit hyperactivity disorder) children with blood lead level of correlation, provide theoretical basis for clinical prevention and treatment of ADHD.Methods: With the help of ten thousand square, VIP, hownet database search data such as in China, from 1979 to 2013 in accordance with the standard reference for Meta analysis.Results: 20 articles were included in the standard, to select 1564 cases of children with attention deifcit hyperactivity disorder (experimental group) and 2156 cases of normal children (control group), blood lead level by Meta analysis, the results different qualitative (2 = 1, 031.151,P< 0.01, I2 = 96.9%), Meta analysis result is stable and subgroup analysis showed that all the research the results of a robust, merger, there were signiifcant difference method of blood lead and blood lead to collect parts subgroup analysis showed that the research still has difference, sensitivity analysis results have no obvious bias, credibility is strong.Conclusion: Domestic children with ADHD has certain correlation with their own blood lead level, the higher blood lead levels are independent risk factors for the development of ADHD, clinical examination and monitoring should be paid attention to when the blood lead level of children.%目的：研究国内ADHD(儿童注意缺陷多动障碍)与血铅水平的相关性，为临床防治ADHD提供理论依据。方法：借助万方、维普、中国知网等数据库搜索资料，对1979-2013年符合研究标准的参考文献进行Meta分析。结果：其中20篇文献符合纳入标准，共选取1564例注意缺陷多动障碍患儿(实验组)，2156例血铅水平正常儿童(对照组)，经Meta分析，各研究结果不同质(2=1031.151， P<0.01，I2=96.9%)，Meta分析的结果稳定，亚组分析显示，各研究的合并结果较稳健，差异均存在显著性，血铅检测方法和血铅采集部位亚组分析显示，各研究仍具有差异性，敏感性分析认为研究结果无明显偏倚，可信性强。结论：国内儿童发生ADHD与自身血铅水平存在一定的相关性，高血铅水平是ADHD的独立危险因素，临床检查或监测时应注意儿童的血铅水平。