注意缺陷多动障碍儿童的神经软体征

Neurological soft signs of children with attention deficit hyperactivity disorder

目的对注意缺陷多动障碍(ADHD)儿童神经软体征的特征及发生率进行调查。方法采用病例对照研究的方法,病例组共74人(其中男生70人,女生4人)均符合DSM-Ⅳ-TR中ADHD的诊断标准,对照组从长沙市某小学随机抽取年龄及性别相匹配的正常儿童,所有研究对象年龄6~12岁之间,右利手,排除重大躯体疾病及其他精神障碍者,所有研究对象进行剑桥神经软体征量表评定,并采用SPSS 16.0软件包进行数据统计分析。结果 ADHD儿童在病例组在神经软体征总分、运动协调得分、感觉整合得分均高于对照组(P<0.05),ADHD儿童在左右侧序列对指运动、奥氏试验、左右侧拳-手-掌试验、右侧实体辨别觉、左右皮肤书写觉、左右指向、去抑制、闪烁、左右镜像运动、左侧翻手运动、感觉消退、左侧手指失认症、Go-nogo试验、左侧镜像运动2中平均分高于对照组,发生率较正常儿童高,差别具有统计学意义(P<0.05)。结论 ADHD儿童中神经软体征发生率较高,存在运动协调、感觉整合及抑制功能障碍,神经软体征可能与ADHD症状产生存在共同的神经病理基础。

Objective To investigate the prevalence and characteristics of neurological soft signs(NSS)in children with attention deficit hyperactivity disorder(ADHD). Methods The case-control study was adopted,the study group(n=74,boy=70,girl=4)children suffered from ADHD meeting a criterion of DSM-Ⅳ-TR,the control group were healthy children randomly selected according to age,sex,from the first grade to the sixth grade of the a primary school of Changsha,Hunan province.All subjects were 6~12years old,right handed.All the subjects were evaluated by the Cambridge Neurological Inventory(CNI).The SPSS 16.0was used to establish database and make statistical analysis. Results Compared to the control group,the prevalence of children with ADHD were higher in Diadockinesia L,Mirror 2L,Go-nogo,Mirror 1L,FgthumbOPP R,Oseretsky,Fist-Edge-Palm L,Fist-Edge-Palm R,Extinction,Fgagnosia L,Stereognosia R,Graphesthesia L,Graphesthesia R,Point to,Wink,Mirror 1R,the differences were significant(P<0.05).The children with ADHD scored higher total scores of NSS,Motor Coordination,sensory integration,the differences were statistically significant(P<0.05). Conclusion The prevalence of neurological soft signs is higher in ADHD patients than control group,ADHD children may have a motor coordination damaged,sensory integration disorder and disinhibition defects,and a potential nervous system dysfunction may under the NSS.