注意缺陷多动障碍儿童行为与执行功能的关联性研究

Correlative study of behavior and executive function in children with attention deficit hyperactivity disorder

目的：探讨注意缺陷多动障碍（ADHD）儿童临床症状与执行功能的关联程度。方法：以符合DSM-Ⅳ诊断标准的59例7~12岁ADHD儿童为研究对象,为病例组,同时招募35例正常儿童为对照组。采用简易智力状态检查、Conner’s儿童行为父母问卷、韦氏记忆量表（倒背和顺背数字测验）和连线测验评估两组儿童外显行为和执行功能中的工作记忆和任务管理能力。进行组间比较和相关分析。结果：①病例组在Conner’s儿童行为父母问卷的品行问题、学习、冲动-多动、多动指数因子得分均高于正常对照组（P＆lt;0.05）。②划线测验B式完成所用的时间（秒）病例组较正常对照组长（P＆lt;0.05）;倒背、顺背得分及总分病例组较正常对照组低（P＆lt;0.05）;病例组在记忆倒背测验中运用组块策略提高记忆成绩的比例明显少于正常对照组（P＆lt;0.05）。③划线测验B式所需时间与学习因子分呈正相关（r=0.409,P＆lt;0.05）;听觉工作记忆测验中倒背得分与焦虑因子分呈负相关（r=-0.510,P＆lt;0.01）;听觉工作记忆测验总分与焦虑因子分呈负相关（r=-0.486,P＆lt;0.01）。结论：①ADHD儿童听觉工作记忆和定式转移能力存在损害;②ADHD儿童某些执行功能与临床症状之间存在相关性。

Objective： To discuss the abnormality of executive function（EF） in children with attention deficit hyperactivity disorder（ADHD） and the correlation between EF and clinical symptoms.Methods： 59 children with ADHD,diagnosed according to criteria of Fourth Edition of Diagnostic and Statistic Manual of Mental Disorder（DSM-Ⅳ）,aged 7~12 years,were involved in the study,with 35 health children as contro1.Two groups were investigated using Conner＇s Parent Rating Scale（PRS）,Wechsler memory scale（digits reciting and reversal reciting）,Mini-Mental State Examination（MMSE） and Tail making test（TMT,AB） to evaluate behavior problem,intelligence,the capacity of auditory short-term memory and working memory as well as complicated mission management.Results： ①By PRS,the scores of morality,learning,impulsion hyperactivity,and hyperactivity index were higher in ADHD group than in health control（HC）（P0.05）.②By TMT,the ADHD children spent more time on part B than HC（P0.05）.The scores of digits reciting was lower in ADHD than in HC（P0.05）.③The score of learning by PRS was positively correlated with the time of TMT（B）（P0.05）,The score of anxiety by PRS was negatively correlated with the scores of digits reciting（P0.01）.Conclusion： Some executive functions,such as working memory and complicated mission management were impaired and correlated with the behavior of ADHD children.