SNAP-Ⅳ评定量表与视听整合连续测试在评估注意缺陷多动障碍中的价值  

Application of the SNAP-Ⅳ and the Integrated Visual and Auditory Continuous Performance Test in evaluating attention deficit hyperactivity disorder

作　　者：谢庆凤 刘一苇[1] 谢媛媛 陈珊 赵凯怡 陈雪尔 潘娟娟 陈翔[1] Xie Qingfeng;Liu Yiwei;Xie Yuanyuan;Chen Shan;Zhao Kaiyi;Chen Xueer;Pan Juanjuan;Chen Xiang(Department of Children′s Rehabilitation,the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University,Wenzhou 325027,China)

机构地区：[1]温州医科大学附属第二医院育英儿童医院儿童康复科,温州325027 [2]温州医科大学附属第二医院育英儿童医院内镜中心,温州325027

出　　处：《中华实用儿科临床杂志》2022年第2期121-125,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：温州市科技局资助项目(Y2020543)。

摘　　要：目的分析斯诺佩评估量表第四版(SNAP-Ⅳ)和视听整合连续测试(IVA-CPT)在注意缺陷多动障碍(ADHD)评估中的一致性和相关性, 为诊断ADHD提供可靠的依据, 降低ADHD诊断的误诊率和漏诊率。方法收集2019年10月至2020年7月于温州医科大学附属第二医院育英儿童医院儿童康复科就诊的ADHD待确诊患儿的评估资料, 对采用SNAP-Ⅳ评定量表测评和IVA-CPT评估的282份数据进行回顾性研究, 采用Kappa检验和Pearson检验分别研究2种方法在ADHD评估中的一致性和相关性。结果 SNAP-Ⅳ评定量表和IVA-CPT在评估ADHD中具有一致性(P<0.000 1), Kappa值=0.514, 总符合率=65.6%;SNAP-Ⅳ评定量表中注意力不集中分量表与IVA-CPT在注意缺陷行为评估中具有一致性(P<0.000 1), Kappa值=0.485, 总符合率=75.5%, SNAP-Ⅳ评定量表中注意力不集中分量表得分与IVA-CPT综合尺度注意商数呈负相关(r=-0.71, P<0.000 1);SNAP-Ⅳ评定量表中多动-冲动分量表与IVA-CPT在多动-冲动行为评估中具有一致性(P<0.000 1), Kappa值=0.585, 总符合率=81.6%, SNAP-Ⅳ评定量表中多动-冲动分量表得分与IVA-CPT综合尺度控制力商数呈负相关(r=-0.74, P<0.000 1)。结论采用SNAP-Ⅳ评定量表和IVA-CPT 2种方法评估ADHD均有一定的价值, 具有较好的一致性和相关性。在诊断ADHD时可联合使用2种测评方法, 提供较全面的诊断依据, 从而降低ADHD的漏诊率和误诊率。Objective To analyze the consistency and correlation between the Chinese Version of Swanson Nolan and Pelham,VersionⅣScale(SNAP-Ⅳ)and the Integrated Visual and Auditory Continuous Performance Test(IVA-CPT)in the assessment of attention deficit hyperactivity disorder(ADHD),thus providing a reliable basis for the diagnosis of ADHD,and reducing the misdiagnosis rate and missed diagnosis rate.Methods Clinical data of children to be diagnosed as ADHD in the Department of Children′s Rehabilitation,Yuying Children′s Hospital of the Second Affiliated Hospital of Wenzhou Medical University from October 2019 to July 2020 were collected.A total of 282 SNAP-Ⅳand IVA-CPT profiles were collected,and the Kappa test and Pearson test were used to retrospectively analyzed for their consistency and correlation in the diagnosis of ADHD.Results SNAP-Ⅳand IVA-CPT were consistent in the diagnosis of ADHD(Kappa value=0.514,total coincidence rate=65.6%,P<0.0001).Inattention subset scores of SNAP-Ⅳwere consistent with the assessment of ADHD by IVA-CPT(Kappa value=0.485,total coincidence rate=75.5%,P<0.0001).Inattention subset scores of SNAP-Ⅳwere negatively correlated with the Full Scale Attention Quotient(FAQ)in IVA-CPT(r=-0.71,P<0.0001).Hyperactivity-impulsive subscale in the SNAP-Ⅳand IVA-CPT were consistent in the assessment of hyperactivity-impulsive behavior(Kappa value=0.585,total coincidence rate=81.6%,P<0.0001).Hyperactivity-impulse subset scores were negatively correlated with the Full Scale Response Control Quotient(FRCQ)in IVA-CPT(r=-0.74,P<0.0001).Conclusions Both SNAP-Ⅳand IVA-CPT have certain diagnostic potential of ADHD,showing good consistency and correlation.They can be both used to provide a more comprehensive diagnosis basis,thereby reducing the misdiagnosis rate and missed diagnosis rate of ADHD.

关 键 词：注意缺陷多动障碍 一致性 相关性 斯诺佩评估量表第四版 视听整合连续测试 

分 类 号：R749.94[医药卫生—神经病学与精神病学]