目的 分析孤独症谱系障碍(ASD)儿童严重挑食与其核心症状之间的关联,为ASD儿童的早期识别和精准干预提供参考。方法 纳入2018年5月—2019年12月在全国13城市的13家医院招募的2~7岁1 349名ASD儿童,1 170名典型发育(TD)儿童;采用自制问卷调查挑食情况,采用孤独症行为量表(ABC)、社会反应量表(SRS)、儿童期孤独症评定量表(CARS)评估ASD儿童核心症状,采用线性回归分析严重挑食对ASD儿童体格生长和核心症状的影响。结果 ASD儿童的严重挑食率为56.5%(763/1 349),TD儿童的严重挑食率为29.7%(348/1 170)。调整混杂因素后,发现患有ASD和两组儿童的年龄是发生严重挑食的影响因素(OR=3.075、1.183、1.156,P＜0.05)。严重挑食显著影响ASD儿童体重、体重指数(BMI)、ABC量表总分及其余分项和SRS量表总分及其余分项(β=-0.220、-0.319、6.305、1.139、2.111、1.043、1.427、0.946、5.908、0.597、1.029、1.517、1.328、1.503,P<0.05)。结论 ASD儿童严重挑食发生率高,持续比例高,同时严重挑食显著影响体重和BMI,并且与ASD核心症状存在关联。为此,临床工作中要关注ASD儿童挑食行为的评估,从而对患儿进行早期识别和精准干预。
Abstract
Objective To investigate the relationship between severely picky eating and the core symptoms among children with autism spectrum disorder(ASD),so as to provide reference for early identification and targeted intervention. Methods From May 2018 to December 2019,1 349 children aged 2 to 7 years were enrolled in this study from 13 hospitals in 13 cities across the country,meanwhile 1 170 typically developed children were recruited. A self-made questionnaire was used to investigate the picky eating status of ASD children. Autism Behavior Scale(ABC),Social Response Scale(SRS) and Childhood Autism Rating Scale(CARS) were used to assess the core symptoms of ASD children. Linear regression was used to analyze the impact of severely picky eating on physical growth and core symptoms of ASD. Results The rate of severely picky eating in ASD children was 56.5%(763/1 349),which was 29.7%(348/1 170) in TD children. It was found that ASD and the age of children in two groups were risk factors for occurrence of severe picky eating after adjusting for confounding factors(OR=3.075,1.183,1.156,P＜0.05). Severely picky eating significantly affected ASD children's weight,body mass index(BMI),scores of ABC scale and subscales,scores of SRAS scale and subscales(β=-0.220,-0.319,6.305,1.139,2.111,1.043,1.427,0.946,5.908,0.597,1.029,1.517,1.328,1.503,P<0.05). Conclusions There is a high incidence and persistence of severely picky eaters in autistic children. Severely picky eating has significant impact on children's weight growth and BMI,and is associated with core symptoms of ASD. Therefore,clinical medical staff should pay more attention to the assessment of picky eating behaviors in ASD children,so as to carry out early identification and precise intervention of children.
关键词
孤独症谱系障碍 /
严重挑食 /
核心症状 /
儿童
Key words
autism spectrum disorder /
severely picky eating /
core symptoms /
children
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基金
国家自然科学基金面上项目(81771223);科技基础资源调查专项(2017FY101100,子课题编号2017FY101103)
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