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目的提高儿童注意缺陷多动障碍(ADHD)诊断、治疗及预后判断的客观性、准确性,观察ADHD患儿认知和智力障碍程度。方法对60例ADHD患儿(ADHD组)和60例健康对照儿童(健康对照组),分别以听觉靶和非靶刺激为诱发事件进行事件相关电位(ERP)P3波检测,采用《中国韦氏儿童智力量表》(C-WISC)检测患儿认知和智力能力,并比较二组儿童不同智力平衡性的ERPP3波测试结果。结果ADHD组患儿较健康对照组儿童P3波潜伏期明显延长(P<0.01),波幅差异不明显。C-WISC检测中总智商(FIQ)、言语智商(VIQ)、操作智商(PIQ)均低于健康对照组儿童(Pa<0.01);66.7%ADHD患儿VIQ低于PIQ15分以上,智力不平衡性明显高于健康对照组(P<0.01)。ADHD组及健康对照组智力不平衡(PIQ-VIQ差值≥15)儿童ERPP3波潜伏期较智力平衡(PIQ-VIQ差值<15)儿童延迟(P<0.05)。结论ERP儿童P3波的潜伏期是评价认知能力的方法,结合C-WISC测试能判断ADHD患儿认知和智力障碍程度,可作为ADHD诊断和预后判定的辅助依据之一。
Objective To improve the objectivity and accuracy of diagnosis, treatment and prognosis of children with ADHD and to observe the degree of cognitive and mental retardation in children with ADHD. Methods Sixty children with ADHD (ADHD group) and 60 healthy control children (healthy control group) were enrolled in this study. Event-related potential (ERP) P3 wave was detected by auditory target and non-target stimulation respectively. Children’s Intelligence Scale (C-WISC) was used to detect children’s cognition and intelligence, and ERPP3 wave test results were compared between children with different intellectual balance. Results The latent period of P3 wave in children with ADHD was significantly longer than that in healthy children (P <0.01), and the difference was not significant. FIQ, VIQ and PIQ in C-WISC test were lower than those in healthy controls (P <0.01); 66.7% of children with ADHD had VIQ less than PIQ15, and had unbalanced intelligence Sex was significantly higher than the healthy control group (P <0.01). In children with ADHD and healthy children, the imbalance of intelligence (PIQ-VIQ difference ≥15) children’s latency of ERPP3 wave latency (PIQ-VIQ difference <15) was delayed (P <0.05). Conclusion The latent period of P3 wave in ERP children is a method of evaluating cognitive ability. Combined with C-WISC test, the cognitive and mental retardation of children with ADHD can be assessed, which can be used as one of the auxiliary evidences for diagnosis and prognosis of ADHD.