【摘要】 目的:探索哌甲酯治疗对注意缺陷多动障碍(ADHD)患者核心症状与执行功能改善的关系。方法:选取85例符合美国精神障碍诊断与统计手册第4版(DSM-IV)ADHD诊断标准的门诊患儿,用哌甲酯控释剂开放治疗,经1～3周的剂量调整,以最适剂量继续治疗4周。采用ADHD评定量表(ADHD-RS-IV)评估核心症状,操作性测查Stroop色词命名测验、Rey复杂图形记忆任务、数字广度、汉诺塔任务、连线测验、言语流畅性和生态学行为评定量表(BRIEF)评估执行功能,分析ADHD-RS-IV减分与执行功能改善分的相关关系。结果:ADHD-RS-IV总分和分量表减分与Rey复杂图形记忆任务延迟结构得分改善分呈低度相关(r=0.19～0.24,均P<0.05);与BRIEF量表减分呈低至中度相关(r=0.19～0.66,均P<0.05),注意缺陷分量表减分与BRIEF量表的总分、元认知指数(MI)及4个因子减分、BRI及抑制因子减分呈中度相关(r=0.51～0.69,均P<0.05),多动冲动分量表减分与BRIEF量表的BRI及抑制因子和中度相关(r=0.54～0.64,均P<0.05)。结论:哌甲酯治疗后ADHD核心症状与执行功能的改善存在相关关系。更多还原

【Abstract】 Objective:To investigate the correlation between the improvements of attention deficit/hyperactivity disorder(ADHD) core symptoms and executive function after methylphenidate treatment.Methods:Eighty-five ADHD children meeting the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-IV) diagnostic criteria were treated open-labeled with the Osmotic release oral system(OROS) methylphenidate.The Core symptoms and executive functions were evaluated at the baseline and the end of the study respectively,with the ADHD Rating Scale(ADHD-RS-IV) for core symptoms,as well as the performance-based tests(Stroop color-word interference task,Rey complex figure test,Digit span,Tower of Hanoi,Trail-making test,Verbal fluency test) and Behavior Rating Inventory(BRIEF) for Executive Function.Pearson correlation was used to analyze the relationship between improvements of core symptoms and executive functions.Results:Only the improvement of delayed structural score in Rey Complex Figure Test for visual working memory was mild correlated to the decrease of ADHD-RS-IV rating scores(r=0.19~0.24,Ps<0.05).The decrease on BRIEF total score,metacognition Index(MI),Behavior Regulation Index,BRI,and each factor were mild to moderate correlated to the decrease of ADHD-RS-IV rating scores(r=0.19~0.66,Ps<0.05),in which,the correlation between the decrease of inattention subscale and those of teacher rated BRIEF total score,MI and its four factors(excluding initiation),BRI and its inhibition factor was moderate(r=0.51~0.69,Ps<0.05),and the correlation between the decrease of hyperactive-impulsive subscale and those of teacher rated BRIEF BRI and its inhibition factor was moderate(r=0.54~0.64,Ps<0.05).Conclusion:It suggests that the ADHD core symptoms improvement after methylphenidate treatment may be correlated with executive function improvement,especially for inattention symptoms moderately correlated to MI improvement,and hyperactive-impulsive symptoms moderately correlated to inhibition improvement.更多还原