Stimulant treatment over 5 years: Effects on growth
Stimulant treatment over 5 years: Effects on growth
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DOI：
10.1097/01.chi.0000199026.91699.20
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发表时间：
2006-04-01
影响因子：
13.3
通讯作者：
Schachar, R
中科院分区：
文献类型：
--
作者：
Charach, A;Figueroa, M;Schachar, R
目的：探讨精神兴奋剂对注意缺陷/多动障碍儿童身高和体重增长的长期影响。方法：研究对象为79名6 - 12岁患有注意力缺陷/多动障碍的儿童，1993 - 1994年、1998 - 1999年每年随访5年。根据2000年美国疾病控制和预防中心的增长图表，每年的身高和体重测量按年龄和性别进行标准化，并以z分数报告。对于在上一学年服用兴奋剂的儿童，剂量效价被标准化为每天每公斤毫克哌醋甲酯。我们使用层次线性模型来研究兴奋剂治疗剂量和持续时间对身高和体重增长速度的影响。结果：在控制治疗开始时间的情况下，每日兴奋剂剂量与身高z评分（β = - 0.11, SE = 0.03, p < 0.01）和体重z评分（β = - 0.29, SE = 0.04, p < 0.01）呈负相关。基于统计模型的估计表明，接受>= 1.5 mg/kg/天哌醋甲酯治疗的儿童在1年后体重增加减少；那些服用>= 2.5 mg/kg/天哌醋甲酯的人在4年后身高的增长会减少。结论：在1 - 5年的时间内长期使用高剂量兴奋剂可能对患有注意力缺陷/多动障碍的学龄儿童的生长速度产生可测量的影响。
Objective: Long-term effects of psychostimulants on growth in height and in weight are investigated in children with attention-deficit/hyperactivity disorder. Method: Participants were 79 children, 6 to 12 years of age, with attention-deficit/hyperactivity disorder, who were followed annually for up to 5 years, between the years 1993 and 1994 and 1998 and 1999. Annual height and weight measurements were standardized by age and gender using the 2000 Centers for Disease Control and Prevention Growth Charts for the United States and reported as z scores. For children taking stimulants throughout the previous school year, dose potency was standardized to methylphenidate in milligrams per kilogram per day. We used hierarchical linear modeling to investigate the influence of dose and duration of stimulant treatment on the rate of growth in height and weight. Results: Controlling for time since initiation of treatment, daily dose of stimulant medication was negatively associated with z scores for height (beta = -.11, SE = 0.03, p < .01) and for weight (beta = -.29, SE = 0.04, p < .01). Estimates based on the statistical model suggest that children receiving >= 1.5 mg/kg/day methylphenidate will show diminished weight gain after 1 year; those receiving >= 2.5 mg/kg/day methylphenidate will show diminished gains in height after 4 years. Conclusion: Long-term use of high doses of stimulants during a period of 1 to 5 years is likely to have measurable effects on the rate of growth in school-age children with attention-deficit/hypperactivity disorder.