目的 分析不同首诊年龄孤独症谱系障碍(ASD)儿童症状严重程度、发育水平及体格发育的状况,为其干预提供依据。方法 选取2022年1月—2023年12月在柳州医院儿童保健科首次诊断为ASD的718名24～98月龄儿童为研究对象并分3个亚组,用孤独症行为量表(ABC)和儿童孤独症评定量表(CARS)评估ASD症状严重程度,Gesell发育诊断量表(GDS)评估发育水平及年龄别身高(HAZ)、年龄别体重(WAZ)和年龄别体重指数(BAZ)评价体格生长状况。用Kruskal-Wallis H检验、χ2检验和Spearman相关分析方法分析各亚组症状、发育水平及体格发育的差异。结果 各年龄组ABC总分、GDS适应性、大运动、精细动作、个人-社交发育商差异均有统计学意义(H=6.840、20.226、35.806、13.009、6.295,P＜0.05);首诊年龄与ABC总分、CARS总分、适应性、大运动、精细动作和个人-社交发育商均呈负相关(r=－0.086、－1.117、－0.184、－0.245、－0.154、－0.172,P＜0.05),与语言发育商无相关性(P＞0.05)。各亚组间HAZ(H=51.845)、WAZ(H=46.156)以及生长迟缓(χ2=39.710)、低体重(χ2=24.382)、消瘦(χ2=6.215)、肥胖(χ2=16.764)检出率差异有统计学意义(P＜0.05),其中72～98月组消瘦、肥胖率高于24~47月龄和48~71月龄组。结论 首诊年龄与ASD严重程度和发育水平相关,不同首诊年龄的ASD儿童存在体格生长偏离,应重视ASD的早期识别、干预及体格发育监测。
Abstract
Objective To analyze the severity of symptoms,developmental levels and physical development of children with autism spectrum disorder(ASD) of differentinitial diagnosis ages, in order to provide evidence for intervention. Methods A total of 718 children aged 24 to 98 months, who were first diagnosed with ASD from January 2022 to December 2023, were selected as the study subjects and divided into three subgroups. The core symptoms of ASD were assessed by Autism Behavior Checklist (ABC) and Childhood Autism Rating Scale (CARS). The Gesell Developmental Scales (GDS) were used to evaluate the developmental level, height for age Z score (HAZ), weight for age Z score (WAZ) and body mass index for age Z score (BAZ) were used to evaluate growth status. Kruskal-Wallis H test, Chi-square test and Spearman correlation analysis were performed to analyze the differences of symptom severity, developmental level and physical development. Results Statistically significant differences were found among thevarious age group in terms of ABC total score, adaptability, gross motor skills, fine motor skills, and personal-social developmental quotient in GDS (H=6.840, 20.226, 35.806, 13.009, 6.295, P<0.05). The age at first diagnosis was negatively correlated with ABC total score, CARS total score, adaptability, gross motor skills, fine motor skills, and personal-social developmental quotient (r=-0.086, -1.117, -0.184, -0.245, -0.154, -0.172, P<0.05), but not correlated with language developmental quotient (P>0.05). There were statistically significant differences in HAZ (H=51.845), WAZ (H=46.156) and the detection rates of growth retardation(χ2=39.710), low body weight(χ2=24.382), wasting(χ2=6.215)and obesity(χ2=16.764) among three subgroups (P<0.05). Specifically, the rates of wasting and obesity in the 72 - 98 months group were higher than those in the 24 - 47 months and 48 - 71 months groups. Conclusions The age of first diagnosis is related to the severity and development level of ASD. Children with ASD at different ages at first diagnosis exhibit deviations in physical growth. Early identification, intervention, and monitoring of physical growth in ASD should be emphasized.
关键词
孤独症谱系障碍 /
年龄 /
症状严重程度 /
体格发育
Key words
autism spectrum disorder /
age /
severity of autism /
physical development
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基金
广西医药卫生自筹经费计划课题(Z20190235)
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