【目的】 探讨事件相关电位(event related potential, ERP)P300对儿童注意缺陷多动障碍(attention deficit hyperactivity disorder, ADHD)不同亚型认知功能缺陷的诊断意义。 【方法】 根据美国精神障碍诊断与统计手册第4版(DSM-IV)对门诊ADHD患儿进行临床分型,分为注意缺陷为主型(ADHD-I组:20例),多动/冲动为主型(ADHD-HI组:20例)和混合型(ADHD-C组:20例),对3组患儿及和正常对照组儿童(20例)应用事件相关电位分析系统进行认知功能评定,并进行组间比较。 【结果】 1)与正常对照组比较,各亚型ADHD患儿的靶刺激在前额区(Fz)、中央区(Cz)、左中央区(C3)、右中央区(C4)及顶区(Pz)各脑区P300潜伏期延长,差异具有统计学意义(F值分别为10.211,6.312,7.418,7.665,7.010);2)各脑区P300波幅下降,差异具有统计学意义(F值分别为4.837,4.698,2.902,3.282,5.275,P值均＜0.05);3)ADHD各亚型之间在以上测验中的组间差异无统计学意义。 【结论】 ADHD各临床亚型患儿的事件相关电位P300没有明显差异,但潜伏期均较正常儿童明显延长,波幅明显降低。

【Objective】 To explore the diagnostic significance of P300 event related potential detect for brain cognitive dysfunction in children with attention deficit hyperactivity disorders. 【Methods】 The ADHD clinical subtypes, including predominantly inattention (PI), predominantly hyperactive-impulsive(HI) and combined type(CT), were classified according to the Fourth Edition of Diagnostic and Statistic Manual of Mental Disorder(DSM-IV) criteria. Sixty unmedicated ADHD children( ADHD-CT, n=20; ADHD-PI, n=20; ADHD-HI, n=20) with age range of 7~13 years were involved in the study, and 20 normal children match by age and gender were recruited as control. All participants were taken the P300 test with the 64-channel event related potential(ERP) and Net station 4.2, then contrast analysis of the latency, amplitude of P300 were made between the four groups. 【Results】 1)The latencies of P300 at forehead zone(Fz), central zone(Cz), left Cz(C3), right Cz(C4) and parietal zone(Pz) in ADHD groups were significantly longer than those in control group(P<0.05). 2)The amplitudes of P300 at Fz, Cz, C3, C4, Pz in ADHD groups were significantly lower than those in control group(P<0.05). 3)There was no difference between the three subtype groups(P>0.05). 【Conclusion】 ADHD has significantly impaired in brain cognitive function, but there is no difference between the three subtype groups.