導語：單(dan)純性肥(fei)胖(pang)對兒童神(shen)經心理發育的影響一文(wen)來源于網友(you)上(shang)傳，不代表本站觀點(dian)，若需要(yao)原創(chuang)文(wen)章可咨詢客服老師，歡迎參考。

摘要:目的探討單純性肥胖對3～6歲兒童神經心理發育的影響。方法(fa)選取2018年(nian)7月至(zhi)2019年(nian)12月本院(yuan)收治的(de)單(dan)純性(xing)(xing)肥(fei)胖兒(er)童(tong)(tong)(tong)65例為單(dan)純性(xing)(xing)肥(fei)胖組(zu)(zu)(zu)(zu)(zu)，同年(nian)齡段正(zheng)常體(ti)重兒(er)童(tong)(tong)(tong)65例為對(dui)照組(zu)(zu)(zu)(zu)(zu)。采用上海復旦大學兒(er)童(tong)(tong)(tong)醫院(yuan)制(zhi)訂的(de)0～6歲兒(er)童(tong)(tong)(tong)發(fa)育(yu)(yu)篩查測驗(DST)量表評估神(shen)經(jing)發(fa)育(yu)(yu)情況;西安交(jiao)大醫學院(yuan)修(xiu)訂的(de)中國(guo)學齡期兒(er)童(tong)(tong)(tong)氣質(zhi)量表評估氣質(zhi)維(wei)度情況。結(jie)果單(dan)純性(xing)(xing)肥(fei)胖組(zu)(zu)(zu)(zu)(zu)兒(er)童(tong)(tong)(tong)精細動作、大運動、社交(jiao)能力、發(fa)育(yu)(yu)商評分(fen)(fen)(fen)均(jun)(jun)(jun)(jun)明(ming)顯低(di)于對(dui)照組(zu)(zu)(zu)(zu)(zu)兒(er)童(tong)(tong)(tong)，差(cha)(cha)異(yi)均(jun)(jun)(jun)(jun)有統(tong)計(ji)學意(yi)(yi)(yi)義(均(jun)(jun)(jun)(jun)P＜0．05);語言和適應能力評分(fen)(fen)(fen)在兩組(zu)(zu)(zu)(zu)(zu)兒(er)童(tong)(tong)(tong)間比較(jiao)差(cha)(cha)異(yi)均(jun)(jun)(jun)(jun)無(wu)統(tong)計(ji)學意(yi)(yi)(yi)義(P＞0．05)。單(dan)純性(xing)(xing)肥(fei)胖組(zu)(zu)(zu)(zu)(zu)兒(er)童(tong)(tong)(tong)節律性(xing)(xing)、適應性(xing)(xing)、趨避性(xing)(xing)、活(huo)動水平、堅持度、反應閾評分(fen)(fen)(fen)均(jun)(jun)(jun)(jun)明(ming)顯低(di)于對(dui)照組(zu)(zu)(zu)(zu)(zu)兒(er)童(tong)(tong)(tong)，差(cha)(cha)異(yi)均(jun)(jun)(jun)(jun)有統(tong)計(ji)學意(yi)(yi)(yi)義(均(jun)(jun)(jun)(jun)P＜0．05);反應強度、心境、注意(yi)(yi)(yi)力分(fen)(fen)(fen)散評分(fen)(fen)(fen)在兩組(zu)(zu)(zu)(zu)(zu)兒(er)童(tong)(tong)(tong)間比較(jiao)差(cha)(cha)異(yi)均(jun)(jun)(jun)(jun)無(wu)統(tong)計(ji)學意(yi)(yi)(yi)義(均(jun)(jun)(jun)(jun)P＞0．05)。結(jie)論3～6歲單(dan)純性(xing)(xing)肥(fei)胖兒(er)童(tong)(tong)(tong)神(shen)經(jing)心理發(fa)育(yu)(yu)水平和氣質(zhi)維(wei)度評分(fen)(fen)(fen)下降，應進行針對(dui)性(xing)(xing)干(gan)預。

關鍵詞:單(dan)純性(xing)肥胖;兒童;神經心理發育;氣質

單純性肥(fei)(fei)胖以全(quan)身脂(zhi)肪堆積或過度增生為主要表(biao)現，是高血壓(ya)、2型糖尿病(bing)等多(duo)種慢性病(bing)發(fa)生的(de)病(bing)理(li)基(ji)礎之(zhi)一(yi)［1］。隨著我國經(jing)濟的(de)快(kuai)速發(fa)展，居(ju)民生活(huo)水平逐(zhu)(zhu)步提高，同(tong)時也帶(dai)來了飲食結構的(de)改變，兒(er)(er)童肥(fei)(fei)胖率逐(zhu)(zhu)年(nian)增加，成為一(yi)項被廣泛關(guan)注的(de)社(she)會問題(ti)［2］。目前，對(dui)兒(er)(er)童單純性肥(fei)(fei)胖的(de)研究多(duo)集中于(yu)探討(tao)相(xiang)關(guan)危(wei)險因(yin)素，而關(guan)于(yu)神(shen)經(jing)心理(li)發(fa)育(yu)(yu)(yu)的(de)研究較(jiao)少。兒(er)(er)童神(shen)經(jing)心理(li)發(fa)育(yu)(yu)(yu)包括(kuo)認知、運(yun)動、人(ren)格等多(duo)個方面，直(zhi)接影響(xiang)到其社(she)會適應能力和身心健康［3］。3～6歲是兒(er)(er)童神(shen)經(jing)心理(li)發(fa)育(yu)(yu)(yu)最快(kuai)的(de)一(yi)個年(nian)齡(ling)段，基(ji)于(yu)此，本(ben)研究探討(tao)單純性肥(fei)(fei)胖對(dui)3～6歲兒(er)(er)童神(shen)經(jing)心理(li)發(fa)育(yu)(yu)(yu)的(de)影響(xiang)。

1對象與方法

1．1研究(jiu)對(dui)象選(xuan)(xuan)(xuan)取(qu)2018年7月至2019年12月本院(yuan)(yuan)收治的(de)(de)單純性(xing)(xing)(xing)肥(fei)胖(pang)兒(er)童(tong)(tong)65例為(wei)(wei)單純性(xing)(xing)(xing)肥(fei)胖(pang)組。入選(xuan)(xuan)(xuan)標準(zhun):①年齡(ling)3～6歲(sui)(sui)(sui);②體(ti)重(zhong)＞同(tong)(tong)身高同(tong)(tong)性(xing)(xing)(xing)別標準(zhun)體(ti)重(zhong)20%。排(pai)除標準(zhun):①內(nei)分(fen)泌代謝疾病所(suo)致的(de)(de)繼發(fa)(fa)性(xing)(xing)(xing)肥(fei)胖(pang);②藥物(wu)引起的(de)(de)肥(fei)胖(pang);③既往有神(shen)經(jing)疾病或心理疾病的(de)(de)兒(er)童(tong)(tong)。入選(xuan)(xuan)(xuan)兒(er)童(tong)(tong)中(zhong)(zhong)男(nan)性(xing)(xing)(xing)35例，女性(xing)(xing)(xing)30例;年齡(ling)3～6歲(sui)(sui)(sui)，平(ping)(ping)均年齡(ling)(4．67±0．53)歲(sui)(sui)(sui)。另選(xuan)(xuan)(xuan)取(qu)性(xing)(xing)(xing)別構(gou)成(cheng)比、年齡(ling)段相(xiang)同(tong)(tong)的(de)(de)正(zheng)常體(ti)重(zhong)兒(er)童(tong)(tong)65例為(wei)(wei)對(dui)照組。其(qi)中(zhong)(zhong)男(nan)性(xing)(xing)(xing)33例，女性(xing)(xing)(xing)32例;年齡(ling)3～6歲(sui)(sui)(sui)，平(ping)(ping)均年齡(ling)(4．61±0．49)歲(sui)(sui)(sui)。兩組基(ji)線資料(liao)(liao)比較差異均無統計(ji)學意(yi)義(yi)(均P＞0．05)，具有可比性(xing)(xing)(xing)。本研究(jiu)經(jing)醫(yi)院(yuan)(yuan)倫理委(wei)員會審(shen)批通(tong)過，所(suo)有兒(er)童(tong)(tong)的(de)(de)監(jian)護人均知(zhi)情(qing)(qing)同(tong)(tong)意(yi)本研究(jiu)。1．2方(fang)法使用上海(hai)復旦大(da)學兒(er)童(tong)(tong)醫(yi)院(yuan)(yuan)制訂的(de)(de)0～6歲(sui)(sui)(sui)兒(er)童(tong)(tong)發(fa)(fa)育篩查測驗(DST)量表(biao)評估(gu)神(shen)經(jing)發(fa)(fa)育情(qing)(qing)況(kuang)，包括精細(xi)運動、大(da)運動、語言、社交及適應(ying)能力5個(ge)維度(du)，計(ji)算(suan)5個(ge)維度(du)總分(fen)的(de)(de)平(ping)(ping)均值為(wei)(wei)智(zhi)齡(ling)，發(fa)(fa)育商=智(zhi)齡(ling)/生物(wu)年齡(ling)×100%。采用西安交大(da)醫(yi)學院(yuan)(yuan)修訂的(de)(de)中(zhong)(zhong)國學齡(ling)期兒(er)童(tong)(tong)氣(qi)質量表(biao)評估(gu)氣(qi)質維度(du)情(qing)(qing)況(kuang)，包括節律性(xing)(xing)(xing)、適應(ying)性(xing)(xing)(xing)、趨避性(xing)(xing)(xing)、活動水平(ping)(ping)等9個(ge)維度(du)。1．3統計(ji)學分(fen)析(xi)采用SPSS23．0統計(ji)學軟(ruan)件包進(jin)行(xing)數(shu)據分(fen)析(xi)，計(ji)量資料(liao)(liao)以x±s表(biao)示并行(xing)t檢驗，P＜0．05為(wei)(wei)差異有統計(ji)學意(yi)義(yi)。

2結果

2．1兩組(zu)神經(jing)心理發(fa)(fa)育情況比(bi)(bi)(bi)較(jiao)見表(biao)1。單純性肥(fei)(fei)胖(pang)組(zu)兒(er)(er)童(tong)(tong)精細動作、大(da)運動、社交能力、發(fa)(fa)育商評(ping)(ping)分(fen)均(jun)明顯低于(yu)對照組(zu)兒(er)(er)童(tong)(tong)，差(cha)異(yi)均(jun)有統(tong)(tong)(tong)計(ji)學意(yi)(yi)(yi)義(yi)(均(jun)P＜0．05);語(yu)言和(he)適(shi)應能力評(ping)(ping)分(fen)在(zai)兩組(zu)兒(er)(er)童(tong)(tong)間(jian)比(bi)(bi)(bi)較(jiao)差(cha)異(yi)均(jun)無統(tong)(tong)(tong)計(ji)學意(yi)(yi)(yi)義(yi)(P＞0．05)。2．2兩組(zu)氣質維度評(ping)(ping)分(fen)比(bi)(bi)(bi)較(jiao)見表(biao)2。單純性肥(fei)(fei)胖(pang)組(zu)兒(er)(er)童(tong)(tong)節律性、適(shi)應性、趨避(bi)性、活動水平、堅持度、反(fan)應閾評(ping)(ping)分(fen)均(jun)明顯低于(yu)對照組(zu)兒(er)(er)童(tong)(tong)，差(cha)異(yi)均(jun)有統(tong)(tong)(tong)計(ji)學意(yi)(yi)(yi)義(yi)(均(jun)P＜0．05);反(fan)應強度、心境、注意(yi)(yi)(yi)力分(fen)散(san)評(ping)(ping)分(fen)在(zai)兩組(zu)兒(er)(er)童(tong)(tong)間(jian)比(bi)(bi)(bi)較(jiao)差(cha)異(yi)均(jun)無統(tong)(tong)(tong)計(ji)學意(yi)(yi)(yi)義(yi)(均(jun)P＞0．05)。

3討論

3～6歲是(shi)兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)神經(jing)(jing)心(xin)(xin)(xin)(xin)(xin)理(li)(li)發(fa)(fa)育(yu)(yu)最迅速的(de)(de)(de)時(shi)期，單(dan)(dan)(dan)(dan)純(chun)(chun)性(xing)(xing)(xing)(xing)肥(fei)(fei)胖(pang)(pang)(pang)在影(ying)(ying)響(xiang)(xiang)兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)身(shen)體(ti)(ti)發(fa)(fa)育(yu)(yu)的(de)(de)(de)同時(shi)還會對(dui)身(shen)心(xin)(xin)(xin)(xin)(xin)健康(kang)產(chan)生長期不(bu)良(liang)影(ying)(ying)響(xiang)(xiang)［4］。相關(guan)研究(jiu)顯示(shi)，兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)自(zi)出(chu)(chu)生起就(jiu)處于神經(jing)(jing)系統(tong)持續發(fa)(fa)育(yu)(yu)過程中(zhong)，而心(xin)(xin)(xin)(xin)(xin)理(li)(li)與身(shen)體(ti)(ti)發(fa)(fa)展(zhan)(zhan)(zhan)具有(you)階(jie)段性(xing)(xing)(xing)(xing)［5］。神經(jing)(jing)系統(tong)是(shi)兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)心(xin)(xin)(xin)(xin)(xin)理(li)(li)發(fa)(fa)育(yu)(yu)的(de)(de)(de)基礎，尤其影(ying)(ying)響(xiang)(xiang)大腦(nao)成(cheng)熟(shu)水(shui)平。心(xin)(xin)(xin)(xin)(xin)理(li)(li)活(huo)(huo)動(dong)(dong)的(de)(de)(de)發(fa)(fa)展(zhan)(zhan)(zhan)與后(hou)天環境影(ying)(ying)響(xiang)(xiang)密切相關(guan)，若外界的(de)(de)(de)學(xue)習、生活(huo)(huo)環境有(you)利于大腦(nao)發(fa)(fa)展(zhan)(zhan)(zhan)，則能(neng)(neng)夠(gou)保證健康(kang)的(de)(de)(de)心(xin)(xin)(xin)(xin)(xin)理(li)(li)活(huo)(huo)動(dong)(dong)［6］。研究(jiu)者發(fa)(fa)現(xian)(xian)，胎齡、出(chu)(chu)生體(ti)(ti)重(zhong)、喂養(yang)方(fang)式(shi)、新生兒(er)(er)(er)(er)(er)期疾病(bing)、窒息史等(deng)(deng)均(jun)(jun)為兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)神經(jing)(jing)心(xin)(xin)(xin)(xin)(xin)理(li)(li)發(fa)(fa)育(yu)(yu)的(de)(de)(de)影(ying)(ying)響(xiang)(xiang)因素(su)，其中(zhong)喂養(yang)方(fang)式(shi)不(bu)科學(xue)是(shi)引發(fa)(fa)兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)單(dan)(dan)(dan)(dan)純(chun)(chun)性(xing)(xing)(xing)(xing)肥(fei)(fei)胖(pang)(pang)(pang)的(de)(de)(de)主要原因之(zhi)一［7］。本(ben)(ben)研究(jiu)結果顯示(shi)，單(dan)(dan)(dan)(dan)純(chun)(chun)性(xing)(xing)(xing)(xing)肥(fei)(fei)胖(pang)(pang)(pang)組兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)精細動(dong)(dong)作、大運動(dong)(dong)、社(she)交能(neng)(neng)力、發(fa)(fa)育(yu)(yu)商評(ping)分(fen)均(jun)(jun)明(ming)顯低于對(dui)照組兒(er)(er)(er)(er)(er)童(tong)(tong)(tong);提示(shi)3～6歲單(dan)(dan)(dan)(dan)純(chun)(chun)性(xing)(xing)(xing)(xing)肥(fei)(fei)胖(pang)(pang)(pang)兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)神經(jing)(jing)心(xin)(xin)(xin)(xin)(xin)理(li)(li)發(fa)(fa)育(yu)(yu)與體(ti)(ti)重(zhong)正常兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)比較(jiao)明(ming)顯更(geng)差。原因可能(neng)(neng)為:肥(fei)(fei)胖(pang)(pang)(pang)兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)在社(she)會交往時(shi)受偏見的(de)(de)(de)比例較(jiao)高，容易出(chu)(chu)現(xian)(xian)羞愧、窘迫等(deng)(deng)情(qing)況(kuang)，提升了對(dui)外界拒絕和不(bu)友(you)好(hao)反饋的(de)(de)(de)敏感性(xing)(xing)(xing)(xing)，對(dui)自(zi)信心(xin)(xin)(xin)(xin)(xin)、自(zi)尊心(xin)(xin)(xin)(xin)(xin)產(chan)生不(bu)良(liang)影(ying)(ying)響(xiang)(xiang)，不(bu)利于神經(jing)(jing)心(xin)(xin)(xin)(xin)(xin)理(li)(li)發(fa)(fa)育(yu)(yu)［8］。本(ben)(ben)研究(jiu)結果同時(shi)發(fa)(fa)現(xian)(xian)，單(dan)(dan)(dan)(dan)純(chun)(chun)性(xing)(xing)(xing)(xing)肥(fei)(fei)胖(pang)(pang)(pang)組兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)節律性(xing)(xing)(xing)(xing)、適應(ying)性(xing)(xing)(xing)(xing)、趨避(bi)性(xing)(xing)(xing)(xing)、活(huo)(huo)動(dong)(dong)水(shui)平、堅持度、反應(ying)閾評(ping)分(fen)均(jun)(jun)明(ming)顯低于對(dui)照組兒(er)(er)(er)(er)(er)童(tong)(tong)(tong);說(shuo)明(ming)3～6歲單(dan)(dan)(dan)(dan)純(chun)(chun)性(xing)(xing)(xing)(xing)肥(fei)(fei)胖(pang)(pang)(pang)兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)氣質(zhi)(zhi)維度評(ping)分(fen)較(jiao)低。可能(neng)(neng)原因為:肥(fei)(fei)胖(pang)(pang)(pang)兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)在進(jin)行戶外活(huo)(huo)動(dong)(dong)時(shi)心(xin)(xin)(xin)(xin)(xin)肺負擔較(jiao)重(zhong)，易出(chu)(chu)現(xian)(xian)心(xin)(xin)(xin)(xin)(xin)慌(huang)、氣短等(deng)(deng)情(qing)況(kuang)，影(ying)(ying)響(xiang)(xiang)了其參加運動(dong)(dong)鍛煉的(de)(de)(de)積極性(xing)(xing)(xing)(xing)，難(nan)以(yi)適應(ying)集體(ti)(ti)活(huo)(huo)動(dong)(dong)［9］;同時(shi)，肥(fei)(fei)胖(pang)(pang)(pang)兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)心(xin)(xin)(xin)(xin)(xin)理(li)(li)負擔較(jiao)重(zhong)，易出(chu)(chu)現(xian)(xian)自(zi)卑、焦慮等(deng)(deng)不(bu)良(liang)情(qing)緒，對(dui)外界刺激的(de)(de)(de)反應(ying)較(jiao)強［10］。綜上(shang)(shang)，3～6歲單(dan)(dan)(dan)(dan)純(chun)(chun)性(xing)(xing)(xing)(xing)肥(fei)(fei)胖(pang)(pang)(pang)兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)神經(jing)(jing)心(xin)(xin)(xin)(xin)(xin)理(li)(li)發(fa)(fa)育(yu)(yu)水(shui)平和氣質(zhi)(zhi)維度評(ping)分(fen)下(xia)降，在日常工作中(zhong)應(ying)針對(dui)上(shang)(shang)述情(qing)況(kuang)加強干預，提升該類兒(er)(er)(er)(er)(er)童(tong)(tong)(tong)神經(jing)(jing)心(xin)(xin)(xin)(xin)(xin)理(li)(li)發(fa)(fa)育(yu)(yu)和氣質(zhi)(zhi)維度水(shui)平。

作者：王曉燕 殷俠 單(dan)位：滕州(zhou)市(shi)中心人民醫院(yuan)新生兒科