注意力缺陷及注意缺陷多动障碍患儿局部脑血流灌注的研究

【目的】探讨注意缺陷／多动障碍(ADHD)各亚型局部脑血流(rCBF)特点以及与不同临床类型的关系。【方法】用单光子发射计算机断层扫描(SPECT)测定了40例ADHD患儿和11例正常儿童rCBF灌注情况。【结果】定性分析结果显示，ADHD患儿低疋BF灌注量的发生率(57．5％)高于正常儿童(9％)，低灌注部位涉及额叶、颞叶、枕叶和丘脑，以额叶发生率最高；伴有多动一冲动组低rCBF注量的发生率(66．7％)高于注意缺陷组(47．3％)，同时，伴有多动一冲动组中在所有疋BF降低的脑区中，左侧占14例次，右侧占10例次，左右侧rCBF差异有显著性。【结论】额叶rCBF降低与ADHD行为抑制缺陷相关，同时左侧脑区血流下降与病情的严重程度相关。

Research on regional cerebral blood flow in children with attention deficit or/and hyperactivity-impulsivity disorder

To understand the characteristic of regional cerebral blood flow (rCBF)of inattentive type and combined subtype of ADHD. rCBF was examined with single photon emission computed tomograghy in 40 children with ADHD and 11 healthy normal boys as controls. Qualitative analysis results showed that the rate of low rCBF was significantly higher in ADHD groups (57.5%)than that in controls(9%).The low rCBF brain zones included frontal lobe, temporal lobe, occipital lobe and thalamus, among which the highest rate was observed in frontal lobe. The rate of low rCBF was significantly higher in the combined subtype groups (66.7%)than that in the inattentive type groups(47.3%).At the same time, the low rCBF in the left brain zones of the combined subtype group was 14 cases,while in the right zones was 10 cases, showing significant difference between the brain zones of the two sides. [Conclusion] The results of the study suggest that the lower rCBF in frontal lobe links up with behavior disinhibition, meanwhile there is relation between the lower rCBF in left brain zones and the intensity of the state of ADHD.