盐酸哌甲酯缓释片对注意力缺陷多动障碍儿童的效果

Effect of Methylphenidate Hydrochloride Sustained-release Tablets in Children with Deficit Hyperactivity Disorder

目的:探讨分析盐酸哌甲酯缓释片改善注意力缺陷多动障碍(ADHD)儿童的临床效果。方法:选取2022年1月—2023年10月莆田市第一医院收治的78例ADHD儿童作为研究对象,将其随机分为对照组和观察组,每组各39例。对照组给予安慰剂,观察组给予盐酸哌甲酯缓释片治疗,连续给药3个月。治疗前后采用磁共振成像(MRI)测量患儿的脑血流灌注信号[脑血流信号强度、舒张末期血流速(Vd)、收缩期峰值血流速度(Vs)、阻力指数(RI)],比较两组治疗前后注意缺陷多动障碍筛查量表(SNAP-Ⅳ)评分、儿童自我意识量表(PHCSS)评分及韦氏儿童智力量表(WISCR)评分。结果:治疗后,观察组患儿脑部双侧的颞叶、枕叶、额叶、顶叶的脑血流信号强度均显著强于对照组,差异有统计学意义(P<0.05)。治疗前两组脑血流参数比较,差异无统计学意义(P>0.05);治疗后,观察组Vd、Vs均显著高于对照组,RI显著低于对照组,差异有统计学意义(P<0.05)。治疗前两组患儿行为评分,差异无统计学意义(P>0.05);治疗后,观察组的多动/冲动、注意力缺陷及对立违抗评分均显著下降,且评分显著比对照组高,差异有统计学意义(P<0.05)。治疗前两组患儿自我意识及智力水平评分比较,差异无统计学意义(P>0.05);治疗后,观察组PHCSS评分和PIQ、VIQ、FIQ评分均显著升高,且评分显著比对照组高,差异有统计学意义(P<0.05)。结论:盐酸哌甲酯缓释片可以显著改善ADHD儿童的脑血流灌注信号和注意力缺陷、多动症状,同时可以提高患儿的自我意识和智力水平。

Objective:To investigate the effect of methylphenidate hydrochloride sustained-release tablets on improving cerebral blood flow perfusion in children with attention deficit hyperactivity disorder(ADHD)based on magnetic resonance imaging(MRI).Method:A total of 78 children with ADHD admitted to the First Hospital of Putian City from January 2022 to October 2023 were selected as the study objects and randomly divided into control group and observation group,with 39 cases in each group.The control group was given placebo,and the observation group was given methylphenidate hydrochloride sustained-release tablets for 3 months.Cerebral blood perfusion signals[cerebral blood flow signal intensity,end-diastolic blood flow velocity(Vd),peak systolic blood flow velocity(Vs),resistance index(RI)]were measured by MRI before and after treatment.The scores of SNAP-IV,PHCSS and WISCR before and after treatment were compared between the two groups.Result:After treatment,the cerebral blood flow signal intensioy of the temporal,occipital,frontal and parietal signals were significantly stronger than those of the control group(P<0.05).There was no significant difference in the comparison cerebral blood flow parameters between the two groups before treatment(P>0.05).After treatment,Vd and Vs in the observation group were significantly lower than RI in the control group,with statistically significant differences(P<0.05).There was no significant difference in the behavioral scores before treatment(P>0.05).After treatment,hyperactivity/impulsivity,attention deficit and opposing violation scores decreased significantly in the observation group,and the scores were significantly higher than those of the control group,with a statistically significant difference(P<0.05).There was no significant difference in the comparison of self-awareness and intelligence scores between the two groups(P>0.05).After treatment,PHCSS scores,PIQ,VIQ and FIQ scores were significantly increased in the observation group,and the scores were significantly higher than the control group,with a statistically significant difference(P<0.05).Conclusion:Magnetic resonance imaging has a high disease diagnosis value in ADHD children,methylphenidate hydrochloride sustained-release tablets can significantly improve the cerebral blood flow perfusion signal,attention deficit,hyperactivity symptoms in children with ADHD,and can improve the self-awareness and intelligence level of children.