摘要目的 探讨注意缺陷多动障碍混合型(C型)和注意缺陷型(Ⅰ型)儿童的认知受损特点及时间进程变化特征.方法 混合型24例,注意缺陷为主型20例,正常对照儿童24例,3组儿童分别完成2个Block时间段的持续性操作测试任务,分别对3组及block1和block2的行为学进行比较分析.结果 1.3组比较:C型和Ⅰ型击中数[(64.37±5.29)个,63.55±5.28)个]分别低于正常对照组[(67.04±2.03)个]；Ⅰ型反应时间[(540.33±90.33)ms]长于正常对照组[(470.56±95.39)ms]；C型和Ⅰ型反应时间变异性(ⅡⅤ)[(174.24±56.35)ms,(201.12±50.79)ms]分别高于正常对照组[(144.72±37.17)ms]；C型1后其他数字虚报数高于Ⅰ型；Ⅰ型总虚报错误反应时间[(701.34±311.54) ms]显著长于C型[(512.57±279.22) ms],差异均有统计学意义(P＜0.05).2.时间进程比较:击中数、遗漏错误数、ⅡⅤ的被试类型主效应显著(F(2,65)分别为3.08,3.08,6.87,P＜0.05)；击中数、遗漏错误数、反应时间、ⅡⅤ的时间进程主效应显著(f(1.65)分别为12.60,12.60,12.30,30.46,P＜0.01)；C型和Ⅰ型Block2的反应时间[(501.82±112.47)ms,559.33±90.73)ms]显著长于Block1[(473.19±106.43)ms,523.45 ±99.86) ms](P＜0.05),而正常对照组差异无统计学意义(P＞0.05).结论 混合型ADHD存在注意缺陷和冲动及反应抑制缺陷；注意缺陷型ADHD为注意缺陷及信息加工速度慢；ADHD的反应速度更易受时间进程影响,ADHD两亚型儿童的认知损害模式不同.

abstractsObjective To investigate the cognitive impairment and time-on-task characteristics of combined type(C type) and predominantly inattentive type (Ⅰ type) of children with attention deficit hyperactivity disorder(ADHD).Methods 24 cases with C type ADHD,20 cases with Ⅰ type ADHD and 24 normal children were completed 2 Block period of continuous performance test task,with conducting a comparative analysis of the behavior results of three groups and block1 and block2.Results 1.three groups comparison:hit numbers of C type (64.37 ±5.29) and Ⅰ type (63.55 ±5.28) were lower than that of the normal control group(67.04 ±2.03) ; reaction time of Ⅰ type (540.33 ± 90.33) ms was longer than that of the normal control group (470.56 ± 95.39)ms; intra-individual variability(ⅡⅤ) of C type (174.24 ± 56.3)ms and Ⅰ type (201.12 ± 50.79)ms were higher than that of the normal control group(144.72 ± 37.17) ms.Commission errors of other figures after 1 of C type was higher than that of Ⅰ type; reaction time of commission errors of Ⅰ type[(701.34 ±311.54) ms] was longer than that of C type((512.57 ± 279.22)ms),and all the differences were statistically significant (P ＜ 0.05).2.Timeon-task comparison:hit numbers,omission errors and ⅡⅤ had the significantly main effect of the type of subjects (P ＜ 0.05) ; hit numbers,omission errors,reaction time and ⅡⅤ had the significantly main effect of time-on-task (P＜0.01) ; Block2 the reaction time of C type and Ⅰ type((501.82 ± 112.47)ms,559.33 ± 90.73)ms) were significantly longer than that of Block1 ((473.19 ± 106.43) ms,(523.45 ± 99.86) ms) (P ＜ 0.05),while no significant difference (P＞0.05) in the normal control group.Conclusions C type ADHD has attention deficit and impulsivity and response inhibition defects.Ⅰ type ADHD has attention deficit and information processing capacity backward.Reaction rate of ADHD is more vulnerable to the impact of time-on-task.Two subtypes of ADHD children has different modes of cognitive impairment.