上海交通大学学报（医学版）

›› 2009, Vol. 29 ›› Issue (7): 789-.

• 专题报道 （儿童保健学） • 上一篇    下一篇

哌甲酯控释剂对注意缺陷多动障碍功能的改善

马 骏, 金星明, 张丽珊   

  1. 上海交通大学 医学院上海儿童医学中心发育行为儿科 上海市环境与儿童健康重点实验室, 上海 200127
  • 出版日期:2009-07-25 发布日期:2009-09-16
  • 作者简介:马 骏（1970—）, 男, 主治医师, 硕士；电子信箱: kcb.163@163.com。

Functional improvement in children with attention deficit hyperactivity disorder after methylphenidate treatment

MA Jun, JIN Xing-ming, ZHANG Li-shan   

  1. Department of Development and Behavioral Pediatrics, Shanghai Key Laboratory of Children's Environmental Health, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
  • Online:2009-07-25 Published:2009-09-16

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摘要：

目的 探讨哌甲酯控释剂对注意缺陷多动障碍(ADHD)儿童核心症状与细化功能的改善作用及两者的相关性。方法 156例确诊为ADHD的患儿，治疗前完成SNAP-Ⅳ量表(中文版)评定；随后给予盐酸哌甲酯控释剂18 mg口服，1次/d，连续1个月；治疗后进行SNAP-Ⅳ量表的二次评定，同时完成细化功能改善问卷评定。观察核心症状与细化功能改善情况，并分析两者的相关性。结果 哌甲酯控释剂治疗后，ADHD患儿SNAP-Ⅳ量表各因子原始平均分均较治疗前明显降低（P<0.001），其中IOWA注意缺陷多动因子减分尤为明显（减分率>50%），其次是多动冲动因子和注意缺陷因子；患儿在校学习、在家作业和社会行为功能都有所改善，且细化功能改善程度明显。注意缺陷因子的减分与在校学习和在家作业情况的改善显著相关（P<0.01）；多动冲动因子和对立违抗因子的减分与社会行为功能的改善显著相关（P<0.05）。结论 哌甲酯控释剂对ADHD儿童的核心症状与细化功能具有改善作用，且两者存在一定相关性；其对各种细化功能改善的效果有所不同。

关键词: 注意缺陷多动障碍, 哌甲酯控释剂, 治疗, 改善

Abstract:

Objective To explore the improvement of core symptoms and detailed function in children with attention deficit hyperactivity disorder (ADHD) after treatment with methylphenidate extended-release tablets, and analyse the relationship between core symptoms reduction and detailed function improvement. Methods One hundred and fifty-six children with confirmed ADHD were rated with Swanson, Nolan, and Pelham, Version Ⅳ (SNAP-Ⅳ)Scale before treatment, then methylphenidate extended-release tablets were orally administered 18 mg once daily for 1 month, and children were rated again by means of SNAP-Ⅳ Scale and detailed function improvement questionnaire. The core symptoms reduction and detailed function improvement were observed, and their relationship was analysed. Results The primary mean scores of each factor in SNAP-Ⅳ Scale decreased significantly after treatment with methylphenidate extended-release tablets（P<0.001）. The reduction rate of factor IOWA/I/O was the most significant (>50%), followed by ADHD-H/Im and ADHD-In. The performance of school study, homework doing and social behavioral function was improved, and the detailed function was significantly improved. The reduction rate in ADHD-In factor was significantly correlated with improvement of school study and homework doing（P<0.01）. The reduction rate in ADHD-H/Im factor was significantly correlated with improvement of social behavioral function（P<0.05）. Conclusion Methylphenidate extended-release tablets play a role in both core symptoms reduction and detailed function improvement in children with ADHD, and core symptoms reduction is related to detailed function improvement to some degree. Methylphenidate extended-release tablets exert different effects on different detailed function.

Key words: attention deficit hyperactivity disorder, methylphenidate, treatment, improvement