癫痫共患ADHD儿童的生态学执行功能

摘要

Objective To study the characteristics of ecological executive function and influencing factors of epilep-tic children with attention deficit hyperactivity disorder ( ADHD) . Methods By utilizing the cross-sectional survey study, 79 cases of epileptic children were evaluated according to the clinical diagnostic scale of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-IV, USA);all of the epileptic children and 52 cases of normal chil-dren with the matched age, gender and levels of education were completed with the questionnaire evaluation of Be-havior Rating Index of Executive Function ( BRIEF, Parents Version) . Results ①30 cases of ADHD were found in 79 cases of children with epilepsy, and the coincidence rate was 37. 97%. There were no statistically significant differences between epileptic children with ADHD and epileptic children without ADHD in gender, age, onset age, education level , course of diseases , control or not , family history and history of traumatic brain injuries . But there were statistically significant differences in epileptic seizure type and drug treatment or not ( P<0. 05 ) . ②The two scores of behavior management index and metacognition were higher in epileptic children with ADHD than the epi-leptic children without ADHD and the normal group, and the differences were statistically significant (P<0. 05).③ The clinical characteristics of seizure type, course of disease, epileptic seizure control or not and drug treatment or not in epileptic children with ADHD were significantly correlated with BRIEF(P<0. 05). Conclusion The eco-logical executive function is comprehensively damaged in the epileptic children with ADHD, and the damage is more serious than the epileptic children without ADHD. The ecological executive function of epileptic children with ADHD is significantly influenced by epilepsy seizure type, epilepsy control or not and drug treatment or not.%目的 探讨癫痫共患注意缺陷多动障碍( ADHD)儿童的生态学执行功能特点及其影响因素. 方法 采用横断面调查研究,对79例癫痫儿童应用美国《精神障碍诊断与统计手册》第4版 ( DSM-IV)标准编制的儿童ADHD临床诊断性会谈量表进行评估. 癫痫儿童与52例年龄、性别、受教育程度与之匹配的正常儿童均完成执行功能行为评定量表(BRIEF)父母版问卷评定. 结果 ① 79 例癫痫儿童中30例共患ADHD,共患率为37. 97%. 癫痫共患ADHD组与非ADHD癫痫组在性别、年龄、起病年龄、受教育程度、病程、控制与否、家族史、脑外伤史方面差异无统计学意义;在癫痫的发作类型、是否药物治疗方面差异有统计学意义(P <0. 05). ② 癫痫共患ADHD组在行为管理指数、元认知两个维度得分均高于非ADHD癫痫组及对照组,差异有统计学意义(P<0. 05). ③ 癫痫共患ADHD组的发作类型、病程、癫痫发作控制与否、服药与否等临床特征与BRIEF显著相关( P<0. 05 ). 结论 癫痫共患ADHD组生态学执行功能全面受损,受损程度比非ADHD癫痫组更严重. 癫痫共患ADHD儿童生态学执行功能受发作类型、癫痫发作控制与否、服药与否等的显著影响.