ADHD和抽动障碍共病儿童的智力结构分析

ANALYSIS OF INTELLIGENCE STRUCTURE OF CHILDREN WITH COMORBID ATTENTION DEFICIT DISORDER WITH HYPERACTIVITY AND TIC DISORDER

目的探讨注意缺陷多动障碍（ADHD）和抽动障碍（TD）共病病儿的智力结构特征。方法采用韦氏儿童智力量表（C-WISC）对ADHD伴TD共病组、单纯ADHD组及正常儿童（对照组）各100例进行智力测验，分别计算各分测验的量表分、言语智商（VIQ）、操作智商（PIQ）和总智商（FIQ），进行对比分析。结果ADHD伴TD共病组病儿C—WISC言语量表中的知识、算术、词汇、理解分测验以及操作量表中的填图、积木分测验及VIQ、PIQ、FIQ均显著低于正常对照组（F＝5．48～1851．04，q＝4．38～10．76，P〈0．01）。单纯ADHD组言语量表中的知识、词汇、理解分测验及操作量表中的填图、积木分测验及VIQ、PIQ、FIQ均显著低于正常对照组（F＝7．42～1851．04，q＝3．32～77．78，P〈0．01）。ADHD伴TD共病组所有分测验得分均低于单纯ADHD组，其中言语量表中的分类、算术、理解分测验以及VIQ、FIQ两组比较有显著性差异（F=3．64～1851．04，q=3．27～70．76，P〈0．05）。结论ADHD伴TD共病、单纯ADHD病儿均存在智力发育落后及智力结构发展不平衡的状况，ADHD伴TD共病组病儿脑损伤更为严重，应引起重视。

Objective To assess the intelligence structure features of children with comorbid attention deficit disorder with hyperactivity （ADHD） and tic disorder （TD）. Methods Children with comorbid ADHD and TD, with ADHD only and normal children, 100 in each group, were evaluated with modified Wechsler Intelligence Scale for Children （C-WISC）. Results Children with ADHD＋TD had significantly lower scores of information, arithmetic, vocabulary and comprehension in verbal subtests and picture completion, block design in performable subtests than those in normal group （F=5. 48- 1 851.04,q=4.38- 10.76, P〈0.01）. Children with ADHD had significantly lower scores of information, vocabulary, comprehension, picture completionand block design than those of the controls （F=7.42-1 851. 04,q=3. 32-77. 78,P〈0. 01）. And the mean scores of FIQ, VIQ, PIQ of ADHD children with or without TD were significantly lower than those of controls. Children with ADHD＋TD had lower scores than those with ADHD only in all items. And the scores of similarities, arithmetic, comprehension, VIQ and FIQ were significantly lower in children with ADHD ＋TD than those with ADHD only （F= 3.64-1 851.04,q= 3.27-70. 76, P〈 0.05）. Conclusion ADHD children with or without TD have lower intellect quotient scores, and their intelligence structure are unbalanced. ADHD children with TD have more severe left brain damage.