摘要
目的:探讨哌甲酯能否改善注意缺陷多动障碍(ADHD)的平衡功能,以及平衡功能变化和临床症状变化之间的关系。方法:评价哌甲酯缓释剂治疗前后23例(男19例,女4例)ADHD患儿的平衡功能,并与年龄相匹配的38例正常男孩的平衡功能相比较。平衡功能的评价使用平衡功能测试仪(SMART EquiTest)中的感觉整合测试(sensory organization test,SOT)。使用ADHD评定量表-Ⅳ(父母版)和父母填写的IOWAConners量表评定症状。结果:治疗后ADHD平均平衡分(75.70±10.30),状态5、6的平衡分(61.84±14.19和65.88±15.41),状态4、5的策略分(89.20±3.17和83.22±6.56),前庭感觉比(67.64±14.43)均高于治疗前(68.70±11.96,49.81±16.26,57.61±16.72,86.84±4.49,78.55±6.55和54.46±17.27,均P<0.05)。治疗前ADHD组男孩平均平衡分(67.95±12.17)和6种状态下的平衡分(分别为90.72±2.49,85.47±6.11,83.42±9.95,70.18±18.03,47.89±16.93和57.00±15.68),状态1的策略分(98.02±1.52),视觉和前庭感觉比(77.20±19.23和52.62±18.15)都低于正常对照组(分别为77.71±6.20,93.14±2.45,89.59±4.22,89.13±5.06,83.11±5.75,60.11±10.11,69.75±12.03,98.68±0.39,89.22±5.43和64.41±10.03,均P<0.05);治疗后ADHD患儿仅有状态1的平衡分(90.82±2.98)和策略分(97.91±1.16)与正常对照组(93.14±2.45和98.68±0.39)相比差异有统计学意义(P<0.05)。治疗前后SOT各项结果的变化幅度和ADHD评定量表总分、注意缺陷分、多动冲动分、IOWA Conners量表I/O和O/D分的减分率之间的相关性差异均无统计学意义(P>0.05)。结论:哌甲酯对平衡系统有直接的作用,能够在一定程度上提高ADHD患儿的平衡功能。
Objective: To explore the effect of methylphenidate on the balance function of children with attention deficit hyperactivity disorder, and the correlation between the variations of balance function and subjective clinical assessment before and after treatment. Methods: From July to December 2006, 23 children (19 boys and 4 girls) who met DSM-Ⅳ criteria for ADHD participated in an open study conducted at Institute of Mental Health, Peking University. The variation of their balance functions before and after methylphenidate extended-release tablets (OROS methylphenidate) treatment were evaluated, and the differences of balance functions between 19 ADHD boys pre- and post-treatment and 38 agematched typically developing control boys were compared. Balance functions were assessed with sensory organization test (SOT) provided by SMART EquiTest system. Subjective clinical assessments were measured with ADHD rating scale-Ⅳ and IOWA Conners rating scale. Results: The equilibrium score (ES) in SOT5, SOT6, and composite score (61.84 ± 14. 19, 65.88 ± 15.41, and 75.70 ± 10.30, respectively), and the strategy score (SS) in SOT4 and SOT5 (89.20 ±3.17 and 83.22 ±6.56), and the sensory analysis of vestibular ratio (67.64 ± 14.43 ) improved significantly after OROS methylphenidate treatment compared to those before treatment (49.81 ± 16.26, 57.61 ± 16.72, 68.70 + 11.96, 86.84 ±4.49, 78.55 ±6.55, and 54.46 ± 17.27, respectively, P 〈0.05) ; Before treatment, the ES in SOT1-6 (90.72 ±2.49,85.47 ± 6.11,83.42 ± 9.95,70.18 ± 18.03,47.89 ± 16.93 and 57.00 ± 15.68) and composite score (67.95 ± 12.17), and the SS in SOT1 (98.02 + 1.52), and the sensory analysis of vestibular and visual ratios (77.20 ± 19.23 and 52.62 ± 18.15 ) of ADHD boys were significandylowerthanthoseoftypicalcontrolboys (93.14 ±2.45,89.59 ±4.22,89. 13 ±5.06,83. 11 ± 5.75, 60.11 ±10. 11, 69.75 ±12.03, 77.71 ±6.20, 98.68 ±0.39, 89.22 ±5.43 and 64.41 ± 10.03, respectively, P 〈0.05) ; After treatment, only in SOT1 the ES (90.82 ±2.98) and SS (97.91 ± 1.16) of ADHD boys were significantly lower than those of control boys (93.14 ±2.45 and 98.68 ± 0.39, P 〈 0.05 ). We did not observe significant correlations between the improvement percentages of SOT results and score reduction percentages on ADHD rating scale-Ⅳ and IOWA Conners rating scale be- fore and after treatment (P 〉 0.05 ). Conclusion: This study suggests that methylphenidate can improve the balance function of children with ADHD through direct effect on the balance system.
出处
《北京大学学报(医学版)》
CAS
CSCD
北大核心
2007年第3期304-309,共6页
Journal of Peking University:Health Sciences
基金
北京市科技计划项目(Y0204003040831)
吴阶平医学基金(CON-CHNⅡ-SOI)
卫生部临床学科重点项目(2004-468)资助~~
关键词
注意力缺陷障碍伴多动
哌醋甲酯
肌肉骨骼平衡
Attention deficit disorder with hyperactivity
Methylphenidate
Musculoskeletal equilibrium