男性注意缺陷多动障碍患儿执行功能缺陷特点的分析  

Analysis of characteristics of executive function deficits of male pediatric patients with attention deficit hyperactivity disorder

作　　者：李梦瑶[1] 杜亚松[1] 江文庆[1] 

机构地区：[1]上海交通大学医学院附属精神卫生中心儿少精神科,上海200030

出　　处：《上海交通大学学报（医学版）》2015年第10期1458-1463,1484,共7页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(81271510);上海市科委引导类课题(15411967500);上海市精神卫生中心特色专科建设(2013-YJTSZK-04)~~

摘　　要：目的分析男性注意缺陷多动障碍(ADHD)患儿的执行功能缺陷特点。方法选取104名门诊ADHD初诊未服药男性患儿和47名正常男性儿童作为研究对象,使用验证性因素分析建立反应抑制、工作记忆、计划性和任务转换4种执行功能的模型,两步聚类法将ADHD组分为不同的执行功能缺陷类别,协方差分析聚类后各组ADHD患儿的症状和执行功能特点,并与正常儿童进行比较。结果经聚类分析后,执行功能缺陷组各项执行功能因子得分均显著低于执行功能完好组和对照组(P<0.001),执行功能完好组的执行功能因子得分与对照组的差异均无显著统计学意义(P>0.05);执行功能缺陷组患儿至少存在1项执行功能缺陷,存在3项或4项缺陷的人数占80.39%;执行功能完好组患儿至多存在2项执行功能缺陷,不存在缺陷者占64.15%。结论男性ADHD患儿执行功能异常率达49.0%,执行功能可达明显受损程度。Objective To analyze the characteristics of executive function （EF） deficits of male pediatric patients with attention deficit hyperactivity disorder （ADHD）. Methods A total of 104 first visit male pediatric outpatients who did not undergo medication and 47 normal boys were enrolled. The confirmatory factor analysis was used to establish models of four executive functions, i.e. response inhibition, working memory, planning, and task shift. The two-step clustering method was adopted to divide the ADHD group into 2 categories with different EF deficits. The analysis of covariance was used to analyze symptoms and characteristics of EF of clustered pediatric patients with ADHD, which were compared with those of normal boys. Results Scores of factors of EF of the impaired-EF group were significantly lower than those of intact-EF group and control group （P〈0. 001） after clustering analysis was conducted. The differences of scores of factors of EF between the intact- EF group and control group were not statistically significant （P〉0.05）. Pediatric patients of the impaired-EF group had at least one EF deficit and 80. 39% of them had 3 or 4 deficits. Pediatric patients of the intact-EF group had up to two EF deficits and 64.15% of them had no deficits. Conclusion 49.0% of male pediatric patients with ADHD have EF deficits and their EF is significantly impaired .

关 键 词：注意缺陷多动障碍 执行功能缺陷 聚类分析 

分 类 号：R749.94[医药卫生—神经病学与精神病学]