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目的研究注意缺陷多动障碍(ADHD)患儿的认知功能,探讨事件相关电位(ERP)在ADHD中的应用及ERP P3波与年龄的相关性。方法 78例ADHD患儿(ADHD组)和78例健康对照儿童(健康对照组)分别按年龄分为3组,即6.50～8.40岁组、8.50～10.40岁组和10.50～12.50岁组。对所有受试者分别进行听觉ERP P3波的检测。应用t检验和Bivariate analyze方法分析资料。结果 1.ADHD组3个年龄段患儿P3波潜伏期均较健康对照组对应年龄儿童延长(Pa<0.01),波幅差异不明显。2.与健康对照组儿童比较,ADHD组患儿靶刺激击中正确率显著降低(P<0.01),误按非靶刺激数显著增多(P<0.01)。3.ADHD组和健康对照组儿童ERP P3波潜伏期与年龄均呈显著负相关(r=-0.448 1、-0.570 4,Pa<0.001),P3波波幅与年龄均呈显著正相关(r=0.269 7、0.317 6,Pa<0.05)。4.ADHD组与健康对照组儿童大脑左中央区(Cz1)、右中央区(Cz2)P3波潜伏期、波幅比较均无统计学差异(Pa>0.05)。结论 ADHD患儿认知功能和排除干扰的能力显著低于健康儿童。ERP P3波测试可作为临床判断ADHD患儿认知障碍的客观指标,对ADHD儿童的诊断、药物疗效和预后判断可能有辅助作用。采用ERP P3波评价ADHD患儿时,要特别考虑年龄问题。
Objective To investigate the cognitive function of children with attention deficit hyperactivity disorder (ADHD) and to explore the application of event related potentials (ERP) in ADHD and the relationship between ERP P3 wave and age. Methods 78 children with ADHD (ADHD group) and 78 healthy control children (healthy control group) were divided into three groups according to their age, namely, 6.50-8.40 years old, 8.50-10.40 years old and 10.50-12.50 years old. Auditory ERP P3 wave was detected in all subjects. Data were analyzed using the t-test and the Bivariate analyze method. Results 1. The P3 wave latency in three age groups of ADHD group was longer than that of healthy control group (Pa <0.01), and the difference was not significant. Compared with children in healthy control group, the accuracy rate of target stimulation in children with ADHD was significantly reduced (P <0.01), and the number of non-target stimulation was significantly increased (P <0.01). There was a significant negative correlation between the latency of ERP P3 wave and age in both ADHD group and healthy control group (r = -0.448 1, -0.570 4, Pa <0.001). The amplitude of P3 wave was positively correlated with age (r = 0.269 7,0.317 6, Pa <0.05). There was no significant difference in the latency and amplitude of P3 wave between the left central area (Cz1) and the right central area (Cz2) of ADHD group and healthy control group (Pa> 0.05). Conclusion Children with ADHD have significantly lower cognitive function and interference ability than healthy children. ERP P3 wave test can be used as an objective indicator of cognitive impairment in children with ADHD, and may be helpful in the diagnosis, drug efficacy and prognosis of children with ADHD. When using ERP P3 wave evaluation of children with ADHD, special consideration should be given to age.