伴铅中毒注意缺陷多动障碍患儿神经心理及行为特征  

Neuropsychological and behavioral characters in attention-deficit hyperactivity disorder children with lead poisoning

作　　者：刘建安[1] 静进[1] 俞红[2] 梁小红[3] 刘勇[4] 陈学彬[1] 

机构地区：[1]中山大学公共卫生学院妇幼卫生系,广东省广州市510089 [2]佛山市妇幼保健院儿保科,广东省佛山市528000 [3]珠海市妇幼保健院儿保科,广东省珠海市519000 [4]中山市博爱医院儿科,广东省中山市528403

出　　处：《中国组织工程研究与临床康复》2007年第17期3313-3315,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：广东省医学科研基金项目(A2002133);广东省哲学社会科学规划教育学研究项目(XLY0301)~~

摘　　要：目的:了解伴铅中毒注意缺陷多动障碍患儿的认知和行为特点。方法:研究对象为2002-09/2005-06在佛山、珠海市妇幼保健院和中山市博爱医院儿童心理科确诊的注意缺陷多动障碍儿童102例。根据患儿血铅水平及儿童铅中毒的诊断标准,分为非铅中毒注意缺陷多动障碍组(简称单纯组)52例和铅中毒注意缺陷多动障碍组(简称合并组)50例。采用韦氏儿童智力量表、韦氏记忆量表、数字划销测验、节律测验、连线测验(甲式)、威斯康星卡片分类测验及Achenbach教师报告量表,对两组患儿的智力、记忆力、注意力、计划功能和学业行为情况进行测评。结果:102例患儿均进入结果分析。①在韦氏儿童智力量表和韦氏记忆量表测试中,合并组患儿全量表智商、注意/不分心及长时记忆分显著低于单纯组(97±10,101±9;96±10,101±10;38±9,42±7,P<0.05)。②在数字划销、节律、连线测试中,合并组患儿数字划消净分显著低于单纯组(158.21±32.92,182.12±45.09);而连线测试得分合并组显著高于单纯组(33.08±15.02,27.19±11.02,P<0.05),而在威斯康星卡片分类测验分类测试中,合并组患儿持续性错误数则显著高于单纯组(21.82±11.18,14.85±8.06,P<0.05)。③在Achenbach教师报告量表评定中,合并组患儿学业情况显著差于单纯组(2.11±1.01,2.52±0.92,P<0.05),同时,注意问题、违纪问题、攻击性行为及外化性行为、行为问题总分则显著高于单纯组(10.02±3.01,8.29±2.91;7.21±3.11,6.01±2.59;13.82±5.88,10.62±6.11;19.69±8.84,16.08±8.14;55.14±20.98,46.09±21.29,P<0.05)。④相关分析表明:血铅水平与注意问题和攻击性行为得分显著正相关(r=0.201,0.181,P<0.05)。结论:伴铅中毒注意缺陷多动障碍患儿的认知和行为受损更广泛和严重。AIM： To investigate the cognitive and behavioral characters in the attention-deficit hyperactivity disorder （ADHD） children with lead poisoning （LP）. METHODS： Totally 102 patients were selected from the Maternal and Child Health Hospitals in Foshan and Zhuhai, as well as Department of Child Psychology, Zhongshan Boai Hospital from September 2002 to June 2005. All the patients were divided into simple grouP （52 children with ADHD） and combined group （50 children with ADHD ＋ LP） on the basis of Pb-B and diagnosis criteria of LP. A series of neuropsychological and behavior tests, such as the Chinese version of Wechsler Intelligence Scale for Children （C-WlSC）, Weohsler. Memory Scale, Number Cancellation Test （NCT）, Rhythm Test, Trail Making Test （TMT）, Wisconsin Card Sorting Card Test （WCST） and Achenbach Teacher＇s Report Form （TRF） were completed simultaneously to determine the intelligence, memory, attention, planning function and academic behavior of those children. RESULTS： All the 102 child patients were involved in the result analysis.①Compared with simple group, the Full Intelli- genca Quotient （FIQ）, the C factor （the Freedom From Distractibility Factor）, and the scores of long term memory in combined group were significantly decreased （97±10, 101±9; 96±10, 101±10; 38±9,42±7, P〈 0.05）.②In NCT, Rhythm Test and TMT, the children of combined group showed significantly lower NCT scores than those of simple group （158.21 ±32.92, 182.12±45.09）. Moreover, the TMT Scores were notably higher in combined group than in simple group （33.08±15.02, 27.19±11.02, P 〈 0.05）, and the perseverati.ve error （PE） of WCST were notably higher in combined group than in simple group （21.82±11.18, 14.85±8,06, P 〈 0.05）.③The results of TRF showed that the academic behavior of children with ADHD ＋ LP was significantly worse then that of children with ADHD （2.11±1.01, 2.52±0.92, P 〈 0.05）, but had more attention, delinquent, aggres

关 键 词：注意力缺陷障碍伴多动 铅中毒 认知 行为 

分 类 号：R135.11[医药卫生—劳动卫生]