CHAT-23量表在江西省儿童孤独症谱系障碍筛查中的应用效果  

Application of Checklist for Autism in Toddlers(CHAT-23) in Screening for Childhood Autism in Jiangxi Province

作　　者：龚俊[1] 罗秀 李维君[1] 钟云莺[1] 钟霞[1] 邱晓露[1] 邹时朴[1] GONG Jun;LUO Xiu;LI Wei-jun;ZHONG Yun-ying;ZHONG Xia;QIU Xiao-lu;ZHOU Shi-pu(Department of Children’s Health,Jiangxi Provincial Children’sHospital,Nanchang 330006,China)

机构地区：[1]江西省儿童医院儿童保健科,南昌330006

出　　处：《南昌大学学报（医学版）》2019年第1期40-43,共4页Journal of Nanchang University：Medical Sciences

基　　金：江西省卫生计生委普通科技计划(20155605)

摘　　要：目的评估婴幼儿孤独症筛查量表(checklist for autism in toddlers-23,CHAT-23)在江西省儿童中的临床应用效果。方法选取于2015年1月至2016年6月在江西省儿童医院就诊的儿童,以CHAT-23量表为筛查工具对其进行孤独症谱系障碍(autism spectrum disorder,ASD)的早期筛查。58例年龄为18～48月龄在心理行为门诊确诊为ASD的儿童为ASD组,同期同年龄在儿童保健科就诊的110例健康儿童为对照组。以美国精神障碍诊断与统计手册第5版(the diagnostic and statistical manual of mental disorders-5,DSM-5)中ASD诊断标准联合儿童孤独症评定量表(childhood autism rating scale,CARS)为ASD诊断标准,对CHAT-23量表进行筛查指标的评价。结果 2组儿童共168例,CHAT-23量表评定为阳性有73例,其中CHAT-23量表并联筛查法评定阳性ASD组为57例,对照组为16例。CHAT-23量表筛查法评估结果:灵敏度=0.98,特异度=0.85,阳性预测值=0.79,Kappa值=0.78。家长问卷条目、核心条目和观察条目ROC曲线下面积(AUC)分别是0.990(P<0.001)、0.979(P<0.001)和0.973(P<0.001)。结论 CHAT-23量表筛查法用时少、成本低、灵敏度高,有较强的筛出ASD患儿的能力,适用于江西省ASD早期筛查。Objective To evaluate the clinical application of checklist for autism in toddlers(CHAT-23) among children in Jiangxi province. Methods Early screening for autism was performed using CHAT-23 in 18-48-month-old children who visited the Jiangxi Provincial Children’s Hospital from January 2015 to June 2016.Among them,58 children diagnosed with autism in the psychological behavior clinic were selected as the ASD group,and 110 healthy children who visited the department of children’s health as the control group.The CHAT-23 evaluation was carried out using the Childhood Autism Rating Scale(CARS) as the diagnostic criteria. Results Among the 168 children,and 73 were positive for CHAT-23(57 in ASD group and 16 in control group).The sensitivity,specificity,positive predictive value and Kappa value of CHAT-23 for screening evaluation results were 0.98,0.85,0.79 and 0.78,respectively.The area under the ROC curve(AUC) was 0.990 for parental items,0.979 for key items,and 0.973 for observation items( P < 0.001). Conclusion The CHAT-23 is a time-saving,low-cost and high-sensitivity tool with strong ability to identify patients for early screening of ASD in Jiangxi province.

关 键 词：孤独症谱系障碍 CHAT-23量表 筛查 ROC曲线 

分 类 号：R749.94[医药卫生—神经病学与精神病学]