盐酸哌甲酯控释剂治疗儿童ADHD临床疗效影响因素分析

Factors influencing efficacy of methylphenidate hydrochloride controlled release agent on children with attention deficit hyperactivity disorder

目的观察中枢神经兴奋剂盐酸哌甲酯控释剂治疗注意缺陷多动障碍(ADHD)患儿临床疗效的影响因素。方法采取自身对照研究方法,选取2014年1月至2015年12月在上海市儿童医院儿保门诊就诊被诊断为ADHD并需要进行治疗的患儿711例;经过盐酸哌甲酯控释剂治疗后,分别于6周、6个月后采用斯诺佩评估量表(SNAP-Ⅳ)的家长使用量表、联合型瑞文测验(CRT)等相关测试,进行治疗前后疗效评估。结果盐酸哌甲酯控释剂对注意力缺陷型和混合型的ADHD患儿治疗效果明显优于多动型/冲动型(χ~2=73.109,P<0.01);对认知功能好的ADHD患儿疗效优于合并认知障碍者(χ~2=100.225,P<0.01)。结论盐酸哌甲酯控释剂治疗儿童不同类型ADHD疗效肯定;疗效受到ADHD类型、患儿智力、药物剂量等的影响。

Objective To observe the influencing factors of clinical effect of methylphenidate hydrochloride controlled release agent as central nervous system stimulant on attention deficit hyperactivity disorder（ ADHD） in children. Methods Method of self-control was used to select 711 children diagnosed as ADHD and needing therapy in Shanghai Children＇s Hospital during the period of January 2014 to December 2015. After treatment with methylphenidate hydrochloride controlled release agent,therapeutic efficacy was evaluated before and after treatment with Swanson Nolan and Pelham Version IV（ SNAP-Ⅳ） and Combined Raven＇s Test（ CRT） at 6 week and 6 month.Results Methylphenidate hydrochloride controlled release agent was more effective to inattentive type and ADHD combined type than to hyperactive-impulsive type（ χ~2= 73. 109,P〈 0. 01）. It was better to ADHD children with good cognitive function than to children with cognition dysfunction（ χ~2= 100. 225,P 〈0. 01）. Conclusion Methylphenidate hydrochloride controlled release agent is effective to different types of ADHD children,and the therapeutic efficacy is influenced by ADHD subtypes,children＇s intelligence and dosage.