注意缺陷多动障碍儿童执行功能与多价不饱和脂肪酸的相关性分析

The corralation of executive function and red blood cell polyunsaturated fatty acids in children with atten- tion deficit hyperactivity disorder in China

目的探讨注意缺陷多动障碍（ADHD）儿童与正常儿童的执行功能差异，及其与红细胞膜多不饱和脂肪酸（PUFAs）的关联程度。方法以符合DSM-Ⅳ诊断标准的7～12岁ADHD儿童为病例组（29例），22例正常儿童为对照组。采用韦氏记忆量表（倒背和顺背数字测验）和连线测验评估2组儿童执行功能中的工作记忆和任务管理能力，同时分别取2组儿童外周静脉血3ml进行外周血红细胞膜（RBC）脂肪酸水平测定。结果（1）病例组完成划线测验B式所用的时间（S）较对照组长[（118．26±40．79）S，（95．55±28．25）S，P〈0．05]，倒背、顺背得分及总分较正常对照组低（P〈0．05）；（2）病例组的血红细胞膜饱和脂肪酸18：0水平高于正常对照组，n-3族不饱和脂肪酸中EPA、22：5（n-3）、DHA水平低于正常对照组，总n-6族和总n-3族不饱和脂肪酸n-6％、n-3％均低于正常对照组（P〈0．05）。（3）划线测验B式所需时间与22：5（n-3）呈负相关（r=-0．288，P〈0．05）；听觉工作记忆测验中顺背得分与22：5（n-3）、DHA、n-3％呈正相关（r=0．313～0．379，P〈0．05），与n-6／n-3呈负相关（r=-0．369，P〈0．01）；听觉工作记忆测验总分与22：5（n-3）、DHA、n-3％呈正相关（r=0．305～0．374，P〈0．05），与n-6／n-3呈负相关（r=-0．320，P〈0．05）。结论（1）ADHD儿童听觉工作记忆和任务管理存在损害；（2）ADHD儿童RBC膜的某些不饱和脂肪酸水平低于正常儿童；（3）ADHD儿童听觉工作记忆和任务管理等执行功能与不饱和脂肪酸之间存在相关性。

Objective To discuss difference of executive function （EF） in children with attention deficit/ hyperactivity disorder （ADHD） in China and the correlation degree of EF and polyunsaturated fatty acid （PUFAs）. Methods 22 children with ADHD were classified according to the Fourth Edition of Diagnostic and Statistic Manual of Mental Disorder （DSM-IV） criteria, with age range of 6 -12 years were involved in the study. 29 health children（HC） were matched by age as control. The two groups were examined using Wechsler memory scale（ digits down-reciting and reversal reciting） and Tail making test （TMT, A＆B） to evaluate intelligence, the capacity of auditory short-term memory and working memory, complicated mission management. At the same time, in knowing the facts agreeing to fetch vein blood for 3 ml in two sets of children down respectively, and determine the thickness of fatty acids in the red cytomembrane. Results （1）In TMT, the ADHD children spent more time on part B than HC （ 118.26 ± 40.79,95.55 ± 28.25, P 〈 0.05 ）. The scores of digits reciting （ train reciting, reversal reciting and the total scores） was lower in ADHD than HC （P〈0.05）. （2）The fatty acid 18：0 was more in ADHD than HC, and EPA, 22： 5（n-3） , DHA, n-6% , n-3% were fewer in ADHD than HC（P〈0.05）. （3）The time of TMT （B） was negatively correlated with 22：5 （ n-3 ） （P 〈 0.05 ）. The scores of digits reciting （ train reci- ting） was positively correlated with 22：5 （ n-3 ）, DHA and n-3% （r = 0. 313 - 0. 379, P 〈 0.05 ） , and negatively correlated with n-6/n-3 （r = -0.369, P〈 0.01 ）. The scores of digits reciting （the total scores） was positively correlated with 22：5 （ n-3 ）, DHA, n-3% （r = 0. 305 - 0. 374, P 〈 0.05 ）, and was negatively correlated with n-6/n-3 （r = - 0. 320, P 〈 0.05 ）. Conclusions （1）The executive function of ADHD children such as working memory and complicated mission management were impaired. （2）The thickness of some kinds of polyunsaturated fatty acids （PUFAs） were lower in ADHD children in China. （3）The thickness of PUFAs were correlated with the executive function of ADHD children such as working memory and complicated mission management.