芬兰的儿科创伤性脑损伤和注意力缺陷/多动症药物治疗:一项基于全国注册的队列研究
Juho Laaksonen1, Ville Ponkilainen2, Julius Möttönen3
1Department of Clinical Medicine, University of Tampere, Tampere, Finland juho.laaksonen@tuni.fi.
BMJ mental health
|August 2, 2024
概括
儿科创伤性脑损伤 (pTBI) 显著增加了注意力缺陷/多动症障碍 (ADHD) 药物使用的风险. 这种关联持续长达20年,强调需要主动预防TBI和长期监测患者.
科学领域:
- 神经科学是一个神经科学.
- 儿科 儿科 儿科
- 公共卫生 公共卫生
背景情况:
- 儿科创伤性脑损伤 (pTBI) 和随后的注意力缺陷/多动症障碍 (ADHD) 药物治疗之间的联系尚不清楚.
- 现有的研究还没有充分探索pTBI对ADHD诊断和治疗的长期影响.
研究的目的:
- 调查小儿创伤性脑损伤 (pTBI) 与注意力缺陷/多动症 (ADHD) 药物治疗的需要之间的关联.
- 在一个大型儿科队列中,量化在pTBI后使用ADHD药物的风险.
主要方法:
- 在芬兰 (1998-2018) 进行的一项全国性回顾性队列研究,涉及66,594名pTBI患者和61,412名患有远端四肢骨折的对照患者.
- 利用芬兰社会保险机构的ADHD药物记录数据,应用1年的洗期,并开始追踪1年后的伤害.
- 使用卡普兰-梅尔分析和考克斯比例危险模型来评估累积发生率和危险比率.
主要成果:
- 与参考组相比,患有pTBI的患者使用ADHD药物的比率明显高,累计发病率在10年内达到3.89%vs1.90%.
- 4年后,pTBI的危险比为1.89,在操作组 (HR 6.31) 显著增加.
- 长期跟踪 (长达20年) 显示持续增加的风险,女性的危险比为2.01,男性的危险比为2.23.
结论:
- 儿童创伤性脑损伤 (pTBI) 与随后需要注意力缺陷/多动症 (ADHD) 药物治疗之间存在显著和持久的关联.
- 研究结果强调了实施PTBI预防策略以及为受影响儿童建立长期监测和精神教育支持至关重要.
关键词:
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