目的 了解××市孤独谱系障碍(autism spectrum disorder,ASD)患病情况,探讨在儿童保健系统中实施ASD早期筛查有效模式。方法 采用分层整群抽样法,抽取1.5~3.0岁幼儿2 090人。应用定期反复三级筛查逐级转诊模式,孤独症筛查量表(CHAT-23)、克氏孤独症行为量表(Clancy Autism Behavior Rating Scale,CABRS)为一级筛查工具,可疑者由儿童精神科医生依DSM-Ⅴ标准进行确诊;半年后复查。结果 首次一级筛查,ASD阳性448人,筛查阳性率21.44%;半年复筛现漏诊4人,假阳性2人;终确诊ASD 26人,患病率1.24%。结论 据DSM-Ⅴ诊断标准,应用CHAT-23和CABRS为一级筛查工具,××市ASD患病率接近美国最近报道,普遍高于国内,提示在儿童保健系统中两量表结合,有助于早期识别ASD;采用定期反复三级筛查逐级转诊模式,利于ASD早期发现和减少漏诊,适合推广。
Abstract
Objective To know the prevalence of the autism spectrum disorders (ASD) in one city,find effective pattern of early screening,realizing early finding and early treating. Methods Across sectional study was conducted with 2 090 children aged from 1.5 to 3.0 years old by stratified cluster sampling.Frequentative step-by-step screening was carried out,CHAT-23 and Clancy Autism Behavior Rating Scale (CABRS) were used as first screening tool,The suspicious were diagnosed by child psychiatrist with DSM-V.After half a year,screening and evaluing all children again. Results In the first step screening,448 children were doubtful,and positive rate was 21.44%,then during the next screening finding that 4 children were missed,2 children were misdiagnosed.The prevalence rate of ASD was 1.24%. Conclusion The prevalence rate of autism spectrum disorders in one city is close to that reported on abroad with the diagnostic criteria of DSM-V,while is much higher than that in other regions in China.That points out that the CHAT-23 and CABRS carrying screening is feasible,and the times and step-by-step screening mode should be popularized during the children's health care system,because that may find early patient effectively and decrease missed diagnosis.
关键词
孤独谱系障碍 /
儿童系统保健 /
早期筛查模式
Key words
autism spectrum disorders /
children&apos /
s health care system /
pattern of early screening
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基金
连云港市“科教兴卫工程”青年科技项目(Q1210)
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