注意缺陷多动障碍患儿与正常儿童前庭系统发育特点比较  

Development of vestibular system in children with/without attention deficit hyperactivity disorder

作　　者：张霞[1] 于立身[2] 王玉凤[1] 

机构地区：[1]北京大学精神卫生研究所,北京100083 [2]解放军空军航空医学研究所

出　　处：《北京大学学报（医学版）》2007年第3期271-276,共6页Journal of Peking University:Health Sciences

基　　金：卫生部临床学科重点项目(2004-468);北京市科技计划项目(Y0204003040831);科技部攻关项目(2004BA720A20)基金资助~~

摘　　要：目的:比较7～14岁正常儿童及注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)患儿的前庭功能发育状况。方法:对符合美国《精神障碍诊断与统计手册(第4版)》(DSM-Ⅳ)诊断标准的148名7～14岁ADHD患儿和同年龄段的正常对照(以两岁作为一个年龄段)使用VTS 2000/VNG-V600型前庭功能测试系统,进行前庭系统检查,比较ADHD患儿和正常对照之间前庭系统的发育特点。结果:正常儿童视眼动反射,特别是扫视、反扫视从7～8岁开始有进一步的发育;从7～8岁到9～10岁,正常儿童扫视、反扫视的延迟时间明显缩短[7～8岁左向扫视延迟时间为(149±66)ms,9～10岁为(108±64)ms,P<0.05;7～8岁反扫视左向延迟时间为(178±127)ms,9～10岁为(101±88)ms,P<0.05],并且扫视的速度明显增快[7～8岁右向扫视速度为(138±12)°/s,9～10岁为(147±15)°/s,P<0.05];从9～10岁到11～12岁这个阶段,反扫视的速度明显增快[9～10岁反扫数左向速度为(155±26)°/s,11～12岁为(172±34)°/s,P<0.05],同时扫视的准确度提高(9～10岁扫视准确度为0.88,11～12岁为0.90,P<0.05)。至13～14岁,正常儿童的扫视延迟时间进一步缩短[11～12岁左向扫视延迟时间为(101±62)ms,13～14岁为(76±63)ms,P<0.05]。ADHD患儿仅在从7～8岁到9～10岁间出现扫视延时的缩短[7～8岁左向扫视延时为(179±67)ms,9～10岁为(138±76)ms,P<0.05],7～14岁ADHD患儿视动性眼震(optokinetic nystagmus,OKN)的速度慢于正常对照组(7～8岁ADHD患儿OKN的慢相速度为138.07°/s,9～10岁为40.24°/s,11～12岁OKN的快相速度为226.88°/s,13～14岁OKN的慢相速度为41.30°/s;7～8岁正常对照OKN的慢相速度为179.03°/s,9～10岁为43.86°/s,11～12岁OKN的快相速度为262.92°/s,13～14岁OKN的慢相速度为47.32°/s),而ADHD患儿视前庭相互作用眼震/(视动性眼震+前庭眼震)慢相速度的比值在7～8岁和11～12岁组大于正常对照组(7～8岁ADHD患儿左向比值为0.73,正常对�Objective： To investigate the development of vestibular system function in 7 to 14 years old normal boys and the ADHD boys; Methods： The present study involved two groups of subjects： 148 ADHD boys （age range 7 years to 14 years） diagnosed with DSM-IV diagnostic criteria and 148 normal boys with the same age. Each group was divided into 4 clusters according to two years gap. All subjects were tested for the vestibular system function by the Vestibular Function Test System 2000/ ENG-V600 with the eye movement index. Results： From 7 to 14 years, the development of vestibular system function in normal boys had the characters as the description below. The optokinetic system function exhibited more development from seven years in the normal group. From 7 to 1 0 years , the time delay of saccade and anti-saccade in normal boys was significantly shorter（ In the normal controls , the delay time of left saccade was 149 ±66 ms in 7 -8 years old boys, 108 ±64 ms in 9 -10 years old boys, 117 ±72 ms in 9 -10 years old boys, the delay time of left anti-saccade was 178 ± 127ms in 7 -8 years old boys, 101 ＋ 88 ms in 9 - 10 years old boys ,P 〈0.05 ）. The velocity of saccade was faster significantly（right saccade velocity was 138 ±11 °/s in 7 -8 years old boys, 147 ± 15 °/s in 9 - 10 years old boys, P 〈0.05）. From 9 to 12 years, the velocity of anti-saccade in normal boys was significantly faster（ left anti-saccade velocity was 155 ±26 °/s in 9 -10 years old boys, 172 ±34 °/s in 11 -12 years old P 〈0.05 and their accuracy of saccade enhanced（ left saccade accuracy was 0.88 in 9 - 10 years old boys, 0.90 in 11 - 12 years old boys ,P 〈0.05） . From 13 to 14 years, time delay was much shorter than before（ the delay time of left saccade was 101 ±62 ms in 11 -12 years old boys, 76 ±63 ms in 13 -14 years old boys, P 〈 0.05 ）. But in ADHD group, there was the different development tendency. Their time delay shorten only in 7 to 10 years old boys（In ADHD group, the delay time of lef

关 键 词：注意力缺陷障碍伴多动 前庭 儿童发育 

分 类 号：R742.89[医药卫生—神经病学与精神病学]