【摘要】 目的了解内蒙古中西部儿童孤独症谱系障碍(autism spectrum disorder,ASD)的患病情况及相关影响因素,为完善国内ASD整体流行病学的调查提供数据支持。方法 2016年9月至2017年6月选择内蒙古中西部包头市、乌海市、巴彦淖尔市3个具有代表性的盟市,采用随机整群抽样的方法,共抽取25所小学及幼儿园的3~14岁儿童16 784名,由主要抚养人填写克氏孤独症行为量表;初筛阳性者再填写孤独症行为检测量表,并结合量表得分由临床专业人员根据美国精神障碍诊断与统计手册第五版诊断标准确诊ASD。结果共检出确诊ASD儿童54例,总体患病率为0.32%(54/16 784),其中男生41例,女生13例。ASD组与正常儿童组性别、家庭经济情况、不良习惯、语言发育水平、父母内向、主要教育方式分布差异均有统计学意义(χ~2值分别为12.344,18.257,22.311,45.959,15.683,35.594,P值均<0.05),两组在是否存在新生儿疾病分布上差异有统计学意义(χ~2=12.214,P<0.05)。Logistic回归分析显示,打骂教育、语言发育落后、父母内向、患有新生儿疾病是ASD发生的危险因素(OR值分别为1.603,2.413,2.818,2.365,P值均<0.05)。结论内蒙古中西部儿童孤独症谱系障碍患病率与国内报道基本一致,低于国外水平。采取改变父母教育方式、调整父母性格、关注儿童早期语言发育水平、避免新生儿期疾病等措施可能会预防儿童ASD的发生。更多还原

【Abstract】 Objective To explore the prevalence and related influencing factors of autism spectrum disorder( ASD) in midwestern Inner Mongolia,and to provide data support for improving the domestic survey on ASD. Methods Three representative city of Inner Mongolia Midwest,including Baotou,Wuhai,Bayinnaoer,were choosen in March 2016 to June 2017,and the method of random cluster was applied to select a total of 16 784 children aged 3 to 14 from 25 primary schools and kindergartens. The questionnaire and clancy autism behavior scale were filled by the main caregivers,and the ones positive in the initial screening were required to fill in the autistic behavior checklist,the ASD was confirmed by clinical professionals in accordance with the DSM-5 and autism behavior check questionnaire score,and midwestern Inner Mongolia ASD prevalence and related factors were analyzed. Results A total of 54 cases in the midwestern Inner Mongolia were diagnosed,the overall prevalence was 0.32%( 54/16 784),among which there were 41 boys and 13 girls,the difference between ASD group and normal children group was statistically significant in gender,the family economic situation,bad habits,language development level,introversion and main education methods of children( χ~2= 12.344,18.257,22. 311,45. 959,15. 683,35. 594,P < 0. 05),there was significant statistical differences between the two groups in the distribution of neonatal disease( χ~2= 12.214,P<0.05). Logistic regression analysis showed that abuse education,language development backwardness,parents’ introversion,neonatal disease were risk factors for ASD( OR = 1.603,2.412,2.818,2.365,P<0.05). Conclusion The prevalence of autism spectrum disorders in children in midwestern Inner Mongolia is consistent with the domestic report,but below the foreign. ASD can be effectively prevented by changing parents’ educational way,adjusting the parents’ personality,focusing on language development level in early childhood,avoiding neonatal diseases and other measures.更多还原