迟缓认知节奏对托莫西汀治疗儿童注意缺陷多动障碍疗效的影响  

Effect of sluggish cognitive tempo on the efficacy of atomoxetine in children with attention-deficit/hyperactivity disorder

作　　者：武文珺 吴迪 徐淑莉 于欢 蔡敏 WU Wenjun;WU Di;XU Shuli;YU Huan;CAI Min(Department of Psychiatry,Xijing Hospital,Air Force Military Medical University,Xi’an 710032,Shaanxi,China)

机构地区：[1]空军军医大学西京医院心身科,西安710032

出　　处：《中国临床医学》2024年第5期790-794,共5页Chinese Journal of Clinical Medicine

基　　金：陕西省自然科学基础研究计划一般项目(2022JQ-908);陕西省重点研发计划一般项目(2023-YBSF-444);西京医院助推项目(XJZT24JC35)。

摘　　要：目的探讨迟缓认知节奏(sluggish cognitive tempo,SCT)对托莫西汀治疗注意缺陷多动障碍(attentiondeficit/hyperactivity disorder,ADHD)疗效的影响。方法前瞻性选择2020年5月至2023年5月于空军军医大学西京医院心身科诊断为ADHD注意力不集中型或混合型的6~12岁患儿,进行8周的托莫西汀治疗。治疗前(基线)、治疗4周后、治疗8周后采用ADHD评定量表(Swanson,Nolan,and Pelham-Ⅳrating scale,SNAP-Ⅳ)评估ADHD症状,同时采用SCT评分量表评估SCT症状。采用Pearson相关分析评价SCT与SNAP-Ⅳ评分改善程度之间的相关性。结果共纳入61例患儿,注意力不集中型10例、混合型51例。所有受试者基线SCT评分与基线SNAP-Ⅳ总分正相关(r=0.490,P<0.001)、与SNAP-Ⅳ评分8周后减分率正相关(r=0.670,P<0.001);治疗8周后SCT总分与基线SNAP-Ⅳ总分正相关(r=0.320,P=0.012);ADHD混合型患者基线SCT评分与SNAP-Ⅳ评分8周后减分率正相关(r=0.578,P<0.001)。结论SCT症状的严重程度与托莫西汀治疗8周后的SNAP-Ⅳ减分率正相关,可作为托莫西汀疗效的预测因子。Objective To explore the impact of sluggish cognitive tempo(SCT)on the efficacy of atomoxetine in the treatment of attention-deficit/hyperactivity disorder(ADHD).Methods A prospective study was conducted.Pediatric patients aged 6-12 years with a diagnosis of ADHD were selected from the Department of Psychiatry,Xijing Hospital,Air Force Military Medical University from May 2020 to May 2023.All the patients were treated with atomoxetine for 8 weeks.ADHD symptoms and SCT symptoms were assessed by Swanson,Nolan,and Pelham-Ⅳrating scale(SNAP-Ⅳ)and SCT rating scale at baseline(before treatment),4 weeks and 8 weeks after treatment.Pearson correlation analysis was used to analyze the correlation between SCT and SNAP-Ⅳscores.Results A total of 61 pediatric patients were enrolled,including 10 cases of inattentive type and 51 cases of mixed type.Baseline SCT score was positively correlated with baseline SNAP-Ⅳscore(r=0.490,P<0.001)and reduction rate of SNAP-Ⅳscore at week 8(r=0.670,P<0.001).The total SCT score at week 8 was positively correlated with total SNAP-Ⅳscore at baseline(r=0.320,P=0.012).The baseline SCT score of patients with mixed type was positively correlated with reduction rate of SNAP-Ⅳscore at week 8(r=0.578,P<0.001).Conclusions The severity of SCT symptoms is positively correlated with the SNAP-Ⅳreduction rate 8 weeks after atomoxetine treatment,which could be a predictor of the efficacy of atomoxetine.

关 键 词：注意缺陷多动障碍 迟缓认知节奏 托莫西汀 疗效 

分 类 号：R749.94[医药卫生—神经病学与精神病学]