盐酸哌甲酯缓释制剂治疗注意缺陷多动障碍儿童临床效果的影响因素研究

Effect of methylphenidate hydrochloride sustained-release preparation on attention deficit hyperactivity disorder in children

目的:探讨注意缺陷多动障碍(ADHD)儿童应用盐酸哌甲酯缓释制剂治疗临床效果的影响因素。方法:选取2018年4月-2019年4月于本院就诊的46例ADHD患儿作为研究对象,均给予盐酸哌甲酯缓释制剂治疗。治疗前采用联合型瑞文测验(CRT)评估患儿智力,并根据国际最新方法将ADHD患儿分为注意力缺陷型、冲动型/多动型和混合型。治疗12周后采用斯诺佩评估量表(SNAP-Ⅳ)由家长进行效果评定。分析性别、年龄、药物剂量、智力水平及不同ADHD分型对临床疗效的影响。结果:性别、年龄对治疗效果的影响比较,差异无统计学意义(P>0.05);小剂量盐酸哌甲酯缓释制剂的治疗效果优于大剂量,差异有统计学意义(P<0.05)。智力水平、不同ADHD分型对治疗效果的影响比较,差异有统计学意义(P<0.05);且智力水平越高,治疗效果越好,治疗显效患儿中,以注意力缺陷型最高,依次是混合型、冲动型/多动型,差异有统计学意义(P<0.05)。结论:盐酸哌甲酯缓释制剂治疗ADHD儿童临床受用药剂量、智力水平、不同ADHD分型因素的影响,临床治疗应最大程度降低相关因素的影响,提高治疗效果,改善患儿预后。

Objective:To investigate the effect of methylphenidate hydrochloride sustained-release preparation in the treatment of attention deficit hyperactivity disorder(ADHD)in children.Methods:A total of 46 ADHD children admitted to our hospital from April 2018 to April 2019 were selected as research subjects,and all of these patients were treated with methylphenidate hydrochloride sustained-release preparation.Before treatment,the combined Raven test(CRT)was used to assess the intelligence of the children.According to the latest international methods,the children with ADHD were divided into attention deficit type,impulsive type/hyperactivity type,and mixed type.After 12 weeks of treatment,the Snowpe scale(SNAP-Ⅳ)effect evaluation was used and conducted by the parents.The effects of sex,age,drug dosage,intelligence level,and different ADHD types on clinical efficacy were also analyzed.Results:There was no statistical significance in the effects of gender and age on the treatment(P>0.05).The therapeutic effect of a low-dose sustained-release preparation of methylphenidate hydrochloride was better than that of a large dose,and the difference was statistically significant(P<0.05).There were statistically significant differences in the influence of intelligence levels and different ADHD types on the treatment effect(P<0.05).The higher grade of intelligence,the better of treatment effect.Among the children with obvious treatment effects,the attention deficit type was the highest,followed by mixed type,impulsive type,and hyperactivity type,and the difference was statistically significant(P<0.05).Conclusions:The treatment of children with ADHD by methylphenidate sustained-release preparation is clinically affected by dosage,intelligence level,and different ADHD classification factors.The clinical treatment should minimize the influence of related factors,improve the treatment effect and improve the prognosis of children.