M-CHAT筛查阳性对孤独症谱系障碍早期诊断稳定性的前瞻性研究

doi:10.11852/zgetbjzz2023-1260

中国儿童保健杂志 ›› 2024, Vol. 32 ›› Issue (10): 1076-1079.DOI: 10.11852/zgetbjzz2023-1260

M-CHAT筛查阳性对孤独症谱系障碍早期诊断稳定性的前瞻性研究

干凯滟¹, 黄安琪^1,2, 张子一¹, 关陆阳¹, 王菲¹, 柯晓燕^1,2

1.南京医科大学附属脑科医院儿童心理卫生研究中心,江苏南京 210029;
2.南京大学医学院

收稿日期:2023-12-18 修回日期:2024-03-16 发布日期:2024-10-11 出版日期:2024-10-10
通讯作者: 柯晓燕,E-mail:kexiaoyan@njmu.edu.cn
作者简介:干凯滟(2000-),女,硕士研究生在读,主要研究方向为儿童孤独症谱系障碍。
基金资助:
国家自然科学基金项目(81971282);南京医科大学孤独症专病队列(NMUC2022010A)

Prospective study of the stability of early diagnosis of autism spectrum disorder with positive screening results of Modified Checklist for Autism in Toddlers

GAN Kaiyan¹, HUANG Anqi^1,2, ZHANG Ziyi¹, GUAN Luyang¹, WANG Fei¹, KE Xiaoyan^1,2

1. Child Mental Health Research Center, Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210029, China;
2. School of Medicine, Nanjing University

Received:2023-12-18 Revised:2024-03-16 Online:2024-10-10 Published:2024-10-11
Contact: KE Xiaoyan, E-mail:kexiaoyan@njmu.edu.cn

摘要/Abstract

摘要： 目的分析改良婴幼儿孤独症检查表(M-CHAT)对疑似孤独症谱系障碍(ASD)婴幼儿的早期筛查结果及临床诊断随访情况之间的一致性,为临床诊疗提供参考依据,提高ASD早期识别率。方法以2017年1月1日—2021年1月1日首次就诊于南京脑科医院儿童心理卫生研究中心的16~30月龄婴幼儿为研究对象,在基线期完成一般资料调查以及全面评估。并在2023年4—9月使用电话随访儿童的诊断情况,分析低于30月龄的高危ASD儿童筛查结果与随后的诊断随访之间的一致性。结果 M-CHAT筛查ASD的敏感度为0.937,特异度为0.514,阳性预测值(PPV)为0.929,阴性预测值(NPV)为0.545,曲线下面积(AUC)为0.726,筛查阳性率在16~23个月和24~30个月两个年龄组比较差异无统计学意义(83.8% vs.90.6%,χ²=2.824,P=0.113)。结论 M-CHAT在ASD患儿早期识别中具有良好的筛查效能,并表现出较好的诊断稳定性。

关键词: 孤独症谱系障碍, 早期筛查, 早期诊断, 改良婴幼儿孤独症量表, 诊断稳定性

Abstract: Objective To analyze the consistency between the early screening Results of the Modified Checklist for Autism in Toddlers (M-CHAT) for infants and toddlers suspected of having autism spectrum disorder (ASD) and their subsequent clinical diagnosis, in order to provide reference for clinical practice and improve the early identification rate of ASD. Methods Infants and toddlers aged 16 to 30 months who first visited the Child Mental Health Research Center of Nanjing Brain Hospital between January 1st, 2017, and January 1st, 2021, were enrolled in the study. General data were collected and comprehensive assessments were completed at baseline. Between April and September 2023, telephone follow-ups were conducted to ascertain the diagnostic status of the children. The consistency between the M-CHAT screening outcomes for high-risk ASD children under 30 months and their later diagnostic follow-ups was analyzed. Results The M-CHAT showed a sensitivity of 0.937, specificity of 0.514, positive predictive value (PPV) of 0.929, negative predictive value (NPV) of 0.545, and an area under the curve (AUC) of 0.726. No statistically significant difference in the positive screening rate was observed between the two age groups of 16 - 23 months and 24 - 30 months old (83.8% vs.90.6%,χ²=2.824,P=0.113). Conclusion The M-CHAT demonstrates good screening efficacy in the early detection of ASD and exhibits a favorable diagnostic stability.

Key words: autism spectrum disorder, early screening, early diagnosis, Modified Checklist For Autism in Toddlers, diagnostic stability

中图分类号:

R749.94

干凯滟, 黄安琪, 张子一, 关陆阳, 王菲, 柯晓燕. M-CHAT筛查阳性对孤独症谱系障碍早期诊断稳定性的前瞻性研究[J]. 中国儿童保健杂志, 2024, 32(10): 1076-1079.

GAN Kaiyan, HUANG Anqi, ZHANG Ziyi, GUAN Luyang, WANG Fei, KE Xiaoyan. Prospective study of the stability of early diagnosis of autism spectrum disorder with positive screening results of Modified Checklist for Autism in Toddlers[J]. Chinese Journal of Child Health Care, 2024, 32(10): 1076-1079.

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M-CHAT筛查阳性对孤独症谱系障碍早期诊断稳定性的前瞻性研究

Prospective study of the stability of early diagnosis of autism spectrum disorder with positive screening results of Modified Checklist for Autism in Toddlers

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