注意缺陷多动障碍不同亚型注意力特征分析

Attention characteristics of children with different clinical subtypes of attention deficit hyperactivity disorder

摘要:

目的 探讨注意缺陷多动障碍（ADHD）儿童不同亚型的注意力特征，为临床干预提供依据。方法 对 345 例 ADHD 儿童进行分型，使用整合视听持续性操作测试（IVA-CPT）进行注意力评估，比较不同亚型的视觉和听觉注意力特征。以 122 例正常儿童作为对照。结果 3 种亚型 ADHD 儿童综合注意力商数和综合控制力商数得分均明显低于正常儿童，差异有统计学意义（P<0.01）；在控制力商数上，多动/冲动为主型（ADHD-HI）儿童听觉得分低于视觉，差异有统计学意义（P<0.05）；在注意力商数、速度商数上，3 亚型ADHD 儿童听觉得分高于视觉，差异均有统计学意义（P<0.01）；在谨慎商数上，视觉得分高于听觉得分，差异有统计学意义（P<0.01）；不同亚型 ADHD 儿童之间听觉注意力相关商数和视觉注意力相关商数差别无统计学意义。结论 ADHD 儿童注意功能低于正常儿童，且视觉注意功能受损重于听觉；不同亚型 ADHD 儿童在视觉和听觉注意力特征上的功能受损程度无差别。

Abstract:

Objective To explore the attention characteristics of children with different clinical subtypes of attention deficit hyperactivity disorder（ADHD) and to provide a basis for clinical intervention.Methods A total of 345 children diagnosed with ADHD were selected and the subtypes were identified. Attention assessment was performed by the intermediate visual and auditory continuous performance test at diagnosis, and the visual and auditory attention characteristics were compared between children with different subtypes. A total of 122 normal children were recruited in the control group and their attention characteristics were compared with those of children with ADHD. Results The scores of full scale attention quotient（AQ) and full scale response control quotient（RCQ) of children with all three subtypes of ADHD were significantly lower than those of normal children（P<0.01). The score of auditory RCQ was significantly lower than that of visual RCQ in children with ADHD-hyperactive/impulsive subtype（P<0.05). The scores of auditory AQ and speed quotient（SQ) were significantly higher than those of visual AQ and SQ in three subtypes of ADHD children（P<0.01), while the score of visual precaution quotient（PQ) was significantly higher than that of auditory PQ（P<0.01). No significant differences in auditory or visual AQ were observed between the three subtypes of ADHD. Conclusion The attention function of children with ADHD is worse than that of normal children, and the impairment of visual attention function is severer than that of auditory attention function. The degree of functional impairment of visual or auditory attention shows no significant differences between three subtypes of ADHD.