注意缺陷多动障碍儿童和青少年反应抑制能力的Meta分析

Meta-analysis of response inhibition capability in children and adolescents with attention deficit hyperactivity disorder

目的探讨注意缺陷多动障碍(ADHD)患儿与正常儿童的反应抑制能力的差异。方法通过检索中国知网(CNKI)、万方、维普和Pubmed、Embase、Cochrane Library共6个中英文数据库,系统收集了1988年8月至2020年2月关于ADHD儿童和青少年反应抑制的相关文献,并提取所有信号停止任务中停止信号反应时间(stop-signal-reaction time,SSRT)的有关数据。按照纽卡斯尔-渥太华文献质量评价量表(Newcastle-Ottawa Scale,NOS)的标准对所纳入的文献进行质量评价。采用RevMan5.3软件对纳入文献进行Meta分析。结果最终纳入19篇文献,包括ADHD病例826例,对照组574例。异质性检验结果显示,各研究间具有轻度异质性(χ2=47.18,P=0.02,I2=36%)。采用固定效应模型进行统计分析,加权均数差(weighted mean difference,WMD)为55.77,95%CI为(48.36,63.17),差异具有统计学意义(χ2=14.76,P<0.00001)。亚组分析提示各亚组的ADHD患儿和对照组间SSRT的差异均具有统计学意义。Bgger’s检验提示不存在明显发表偏倚。结论 ADHD患儿反应抑制能力明显低于正常儿童,反应抑制能力不足可能是ADHD患儿行为、情绪管理不良的主要原因。

ObjectiveTo explore the difference in response inhibition capability between children with attention deficit hyperactivity disorder(ADHD)and healthy children.MethodsBy systematically searching CNKI,Wanfang,VIP,Pubmed,Embase,Cochrane Library,a total of 6 Chinese and English databases,the authors collected relevant literature on the response inhibition of ADHD children and adolescents from August 1988 to February 2020,and extracted the relevant data of stop-signal-reaction time(SSRT)in all signal-stop tasks. Newcastle-Ottawa Scale(NOS)was used to evaluate the quality of the included studies. RevMan5.3 was used to conduct meta-analysis.ResultsA total of 19 studies were finally included,with 826 ADHD cases and 574 controls. Heterogeneity results showed that there was mild heterogeneity among the studies(χ2=47.18,P=0.02,I2=36%). Fixed effects model was used for statistical analysis. The weighted mean difference(WMD)was 55.77(95%CI:48.36 to 63.17),and the difference was statistically significant(χ2=14.76,P<0.00001). Subgroup analysis showed that the differences in SSRT between ADHD children and control groups in each subgroup were statistically significant. Bgger’s test suggested that there was no obvious publication bias.ConclusionThe children with ADHD have significantly reduced response inhibition capability than healthy children,and the lack of response inhibition capability may be the main reason for behavioral and emotional disorders in ADHD.