孤独症谱系障碍儿童胃肠问题检出情况初探  

Detection rate of gastrointestinal problems in children with autism spectrum disorder

作　　者：李珂[1,2] 江晓东 季忆婷[1,2] 李斐 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心发育行为儿科,上海200127 [2]上海交通大学医学院附属新华医院环境与儿童健康教育部和上海市重点实验室,上海200092 [3]重庆医科大学附属儿童医院儿童保健科,重庆400014 [4]上海交通大学医学院附属新华医院发育行为儿童保健科,上海200092

出　　处：《上海交通大学学报（医学版）》2017年第11期1506-1511,共6页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(81270397);上海市教育委员会高峰高原学科建设计划(20152234)~~

摘　　要：目的·探索孤独症谱系障碍(ASD)儿童胃肠问题检出率及分布情况。方法·纳入在上海交通大学医学院附属上海儿童医学中心及附属新华医院发育行为儿科就诊的3~8岁ASD患儿336名。所有患儿均符合《精神疾病诊断与统计手册》第5版诊断标准。由父母或照养人填写患儿一般资料,包括出生年月、性别及近3个月胃肠问题现况等。探索胃肠问题在此人群中的检出率及分布情况。结果·336例ASD患儿中,胃肠问题阳性85例,总体检出率25.3%。其中便秘59例(17.6%),呕吐12例(3.6%),腹泻11例(3.3%),腹痛7例(2.1%),腹胀6例(1.8%)。在3~8岁合并胃肠问题的ASD儿童中,不同年龄组之间胃肠问题检出率的差异无统计学意义(χ~2=1.511,P=0.680),胃肠问题严重度的差异也无统计学意义(F=0.773,P=0.513)。结论·胃肠问题在ASD儿童中较常见,且在3~8岁年龄段持续存在,其严重度不随年龄增长而降低。提示ASD儿童胃肠问题,尤其是便秘,需作为慢病管理的一部分,其评估和治疗值得临床关注。Objective · To explore the detection rate of gastrointestinal problems in autism spectrum disorder （ASD） children. Methods · 336 ASD children aged from 3-8 years old in Department of Developmental and Behavioral Pediatrics in Shanghai Children’s Medical Center and Xinhua Hospital were recruited to the study according to the inclusion and exclusion criteria. All of the children met diagnostic criteria of ASD in Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. General information about the children, including birth date, gender and gastrointestinal problems during recent 3 months, were completed by parents or caretakers. The detection rate of gastrointestinal problems was depicted in this population. Results · Among 336 ASD individuals, gastrointestinal problems were detected in 85 children. General detection rate for gastrointestinal problems is 25.3%. Specifically, 59 （17.6%） children were with constipation, 12 （3.6%） children with vomiting, 11 （3.3%） children with diarrhea, 7 （2.1%） children with abdominal pain and 6 （1.8%） children with abdominal bloating. There was no significant difference in detection rate for gastrointestinal problems among different age groups （χ2=1.511, P=0.680）, as well as in severity scores for gastrointestinal problems （F=0.773, P=0.513）. Conclusion · Gastrointestinal problems are often found in Chinese ASD children and persistently occurred in children aged 3 to 8 years old, but the severity score for gastrointestinal problems did not significantly decrease as age increased. More concern must be paid to gastrointestinal problems, especially to constipation. Gastrointestinal problems should be taken as a part of chronic disease management in ASD children.

关 键 词：孤独症谱系障碍 胃肠问题 检出率 便秘 严重度 

分 类 号：R725.7[医药卫生—儿科] R749.94[医药卫生—临床医学]