注意缺陷障碍的临床研究  

The clinical research in ADHD

作　　者：金星明 章依文 王建忠[2] 

机构地区：[1]上海儿童医学中心儿保科,200127 [2]江苏省常熟市中医院,215500

出　　处：《中国实用儿科杂志》2005年第1期18-20,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的　探讨注意缺陷障碍 (ADHD)儿童的诊断、分型和性别差异。方法　根据DSM IV诊断标准 ,对2 0 0 3年 10月至 2 0 0 4年 3月因多动、注意力不集中、成绩下降而就诊上海儿童医学中心儿保门诊的 2 32例儿童进行诊断和分型 ;应用韦氏智力量表对诊断为ADHD儿童进行智力测试 ,比较男女儿童在智力结构及核心症状发生率的差异 ,并对核心症状进行聚类分析。结果　确诊为ADHD者 118例 ,女性儿童算术、拼图量表分明显落后于男性儿童 ,且语言智商、操作智商、总智商也低于男性儿童 (P <0 0 5 ) ;ADHD亚型中 ,以注意缺陷型为最多 ,其次为混合型 ,共 4 1例 ,多动冲动型最少 ,3个亚型中 ,男女发生率无性别差异 ;ADHD儿童核心症状的聚类分析结果有 4类 ;ADHD和非ADHD儿童不同性别核心症状的比较显示 :女性ADHD和非ADHD儿童之间的差异没有男性明显。结论　因多动、注意问题就诊的儿童中一半为ADHD ,其分型无性别差异。ADHD女性儿童智力明显落后于男性儿童。ADHD核心症状聚类分析有 4类。女性ADHD ,尤其多动冲动型的诊断过程中需考虑我国的文化差异。Objective To discuss the diagnosis and types of children with attention deficit hyperactivity disorder(ADHD) and their difference in gender.Methods We diagnosed 118 of 232 children who presented hyperactivity,attention problem,learning problem in our clinic as ADHD and classified the types according to DSM Ⅳ.We also applied WISC R to test the intelligent quotient(IQ) of these children.Then we compared boys' intelligent structure and core symptoms with girls'.Moreover,we applied clustering analysis to core symptoms.Results Among these children ADHD accounts for 50.9%.The girls' subscale scores of the arithmetic item and piecing pictures were much lower than boys'.The language IQ,performance IQ and general IQ of girls were also lower than that of boys(P<0.05).Among the types of ADHD,the first one was attention deficit,the second one mixed type,and the third one hyperactivity impulse.There was no gender difference in the incidences of three types.The difference of core symptoms between girls with ADHD and girls without ADHD was less significant than that between boys with ADHD and boys without ADHD.Conclusion Among children who presented hyperactivity,attention problem,learning problem and ADHD account for about half of these children.There is no gender difference between different types of ADHD.The ADHD girls' IQ is significantly lower than ADHD boys'.There are 4 cluster groups in clustering analysis of core symptoms of ADHD.We should consider the cultural difference in diagnosing girls as ADHD,particularly in hyperactivity impulse type.

关 键 词：注意缺陷障碍 性别 认知结构 聚类分析 核心症状 

分 类 号：R72[医药卫生—儿科]