不同亚型注意缺陷多动障碍患者的认知功能比较

Comparison of the cognitive functions of patients with two subtypes of attention deficit hyperactivity disorder

【目的】探讨注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)患儿中注意缺陷为主型(predominantly inattentive type,PI)和混合型(combined type,CT)的认知特征差别,为ADHD患儿的临床干预和治疗提供依据。【方法】根据美国精神障碍诊断与统计手册第4版诊断和分类标准,将171例ADHD患儿分为PI和CT两个亚型。采用韦氏儿童智力量表、威斯康星卡片分类测验、持续性注意测试和数字划消测验,对比分析PI型和CT型患儿的认知特点。【结果】韦氏儿童智力测验中CT型的算术得分和总智商得分要高于PI型,持续性注意测试中CT型在点击数、虚报错误数及其T分上高于PI型(P均<0.05)。两个亚型的患儿在威斯康星卡片分类测验和数字划销各指标的比较上差异无统计学意义。【结论】CT型患儿在一般智力水平上高于PI型,但CT型患儿反应抑制能力的受损较PI型更明显。

[Objective] To investigate the cognitive function differences of predominantly inattentive subtype （PI） and combined subtype （CT） of attention deficit hyperactivity disorders （ADHD） patients,and provide references for clinical intervention for ADHD. [Methods] 171 children with ADHD were diagnosed and classified into three subtypes：PI, HI and CT according to DSM-IV criteria for ADHD. The Chinese Wechsler Intelligence Scale for Children （C-WlSC）.Wisconsin Card Sorting Test （WCST）,Continue Performance Test （CPT） and Number Cancellation Test （NCT） for Children were conducted to assess children＇s cognitive function. [Results] Compared to Patients with PI subtype,patients with CT sub- type had higher scores both in arithmetic and full intelligence quotient subscales of the Chinese wechsler intelligence scale for children and in click number,error number and T score of error number of the continuous performance test（P all^0.05）. There were no statistically significant differences in WCST and NCT between CT and PI subtype. [Conclusion] Patients with CT subtype has higher general intelligence level and more impairment in response inhibition than those with PI subtype.