目的 探索改良婴幼儿孤独症量表中文简化版(M-CHAT中文简化版)在3～4岁儿童中筛查孤独症谱系障碍(ASD)的应用价值,并制定合适界值。方法 在2018年1—12月期间,选取年龄在3～4岁之间临床诊断为ASD儿童48例及正常发育儿童96名为研究对象,对其分别进行M-CHAT中文简化版评定,并绘制ROC曲线,以评价该量表在3～4岁儿童中筛查ASD的价值。结果 M-CHAT中文简化版在3～4岁儿童中筛查ASD时,其ROC曲线下面积AUC为0.94(95%CI:0.893～0.975);当筛查界限分为13分时,M-CHAT中文简化版区别ASD和非ASD能力最高,其灵敏度为0.94(95%CI:0.828～0.987)、特异度为0.82(95%CI:0.732～0.893)、Youden指数为0.76、阳性概率比5.29(95%CI:3.400～8.200)、阴性概率比0.08(95%CI:0.030～0.200)、阳性预测值为72.58%、阴性预测值为96.34%。结论 M-CHAT中文简化版筛查3～4岁ASD儿童能力较强,值得在3～4岁年龄段儿童ASD筛查工作中推广应用。
Abstract
Objective To explore the application value of Chinese simplified version of M-CHAT to screen autism spectrum disorder (ASD) in children aged 3 to 4 years,and to establish appropriate thresholds. Methods A total of 48 ASD children aged 3 to 4 years and 96 normal developing children were selected as subjects from January 2018 to December 2018. The Chinese simplified version of M-CHAT was used and ROC curve was drawn to evaluate the value of the scale in screening ASD among children aged 3 to 4 years. Results Using the Chinese simplified version of M-CHAT in screening ASD in children aged 3 to 4 years old,the area under the curve(AUC) was 0. 94 (95%CI:0. 893―0. 975). When the cutoff point was divided into 13,the Chinese simplified version of M-CHAT showed the highest ability to distinguish ASD from non-ASD. Its sensitivity was 0. 94 (95% CI:0. 828―0. 987),specificity was 0. 82 (95% CI:0. 732―0. 893),Youden index was 0. 76,positive probability ratio was 5. 29 (95% CI:3. 400-8. 200) and negative probability ratio was 0. 08 (95% CI:0. 030―0. 200). The positive predictive value was 72. 58% and the negative predictive value was 96. 34%. Conclusion The Chinese simplified version of M-CHAT shows strong ability to screen ASD children aged 3 to 4 years,and is well worth popularizing and applying in ASD screening for children aged 3 to 4 years.
关键词
孤独症 /
M-CHAT中文简化版 /
儿童
Key words
autism /
Chinese simplified version of M-CHAT /
children
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参考文献
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基金
广东省医学科学技术研究基金(B2018141)
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