目的 探讨孤独症谱系障碍发病的影响因素,为孤独症谱系障碍的病因、发病机制及防治提供依据。方法 采用自制的孤独症谱系障碍影响因素调查表对80例孤独症谱系障碍患儿和80例正常儿童进行病例对照研究。结果 经非条件多因素回归分析结果显示,有统计学意义的各个危险因素中,对孤独症谱系障碍发病的影响值从大到小依次为:过期产(OR=20.396,P<0.01),人工喂养(OR=7.567,P<0.01),新生儿黄疸(OR=7.234,P<0.01),宫内或新生儿缺氧(OR=6.411,P<0.05),孕期接触不良因素(OR=3.354,P<0.01),塑料玩具(OR=3.115,P<0.01),母亲性格内向(OR=2.086,P<0.05),而常规的家庭教育为保护因素(OR=0.093,P<0.01)。结论 孤独症谱系障碍儿童的发病可能与遗传,环境因素,孕期和出生高危因素存在一定关系,控制这些因素可能会降低孤独症谱系障碍的发生。
Abstract
Objective To investigate the risk factors affecting children with autism spectrum disorder (ASD) and to offer basis for etiology,pathogenesis and prevention for ASD. Methods A total of 80 children with ASD and 80 normal children were investigated in this case-control study.Risk factors were obtained through self-administered questionnaires which were completed by parents. Results Logistic analysis according to their contributive values showed the risk factors were postterm delivery (OR=20.396,P<0.01),atificial feeding (OR=7.567,P<0.01),neonatal jaundice (OR=7.234,P<0.01),hypoxia (OR=6.411,P<0.05),risk factors during pregnancy (OR=3.354,P<0.01),plastic toys (OR=3.115,P<0.01) and mother's introversion character (OR=2.086,P<0.05).However,regular family education was the protect factor. Conclusions The environment factors,the unfavorable events in pregnant and delivery,the neonatal and developmental phase could increase the incidence of autism spectrum disorder.Some effective should be taken to control these risk factors.
关键词
孤独症谱系障碍 /
孤独症 /
影响因素 /
危险因素 /
儿童
Key words
autism spectrum disorder /
autism /
influencing factor /
risk factor /
childhood
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参考文献
[1] American Psychiatric Association.Diagnostic and statistical manual of mental disorders[M].5th ed.Arlington,VA:American Psychiatric Association,2013.
[2] CDC.Prevalence of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network,11 Sites,United States,2010[J].MMWR,2014,63(SS02):1-21.
[3] 赵夏薇.孤独症临床危险因素相关研究与进展[J].中国儿童保健杂志,2008,16(1):67-69.
[4] 田疆.儿童孤独症危险因素的研究[D].天津医科大学,2006.DOI:10.7666/d.y881030.
[5] 张雅丽,牛小媛.孤独症危险因素探讨[J].长治医学院学报,2012,26(3):181-184.
[6] 孙彩虹,王佳,孙礼,等.孤独症儿童与正常儿童父母个性特征比较[J].中国学校卫生,2010,31(2):131-133.
[7] 冼丹霞,金宇,谢笑英,等.儿童孤独症发病危险因素的病例对照研究[J].中国儿童保健杂志,2014,22(1):24-27.
[8] 林艳,万国斌,袁世新.孕期危险因素与儿童孤独症关系的 Meta 分析[J].中国妇幼保健,2012,27(021):3359-3362.
[9] Guinchat V,Thorsen P,Laurent C,et al.Pre‐,peri‐and neonatal risk factors for autism[J].Acta obstetricia et gynecologica Scandinavica,2012,91(3):287-300.
[10] Zhang X,Lv CC,Tian J,et al.Prenatal and perinatal risk factors for autism in China[J].Journal of autism and developmental disorders,2010,40(11):1311-1321.
[11] 张真.温州地区儿童自闭症临床资料分析[D].温州医学院,2011.
[12] 王哲.儿童孤独症的病因及影响因素初探[J].中国妇幼保健,2012,27(035):5834-5834.
[13] 戴旭芳.自闭症儿童与普通儿童的饮食状况比较研究[J].中国特殊教育,2006,77(11):4-6.
[14] 赵冬梅,王广新,尚晓瑞,等.145例儿童孤独症的危险因素分析[J].中国保健营养:中旬刊,2013,(9):796-796,797.
[15] 张静,赵桂兰,徐翠青,等.家庭因素与儿童孤独症的病例对照研究[J].中国妇幼保健,2009,24(6):777-779.
基金
青岛市科技局科研基金资助项目(KJZD-12-22-nsh)