孤独症谱系障碍患儿胃肠问题与症状表现关联研究  

Association between gastrointestinal problems and symptoms in children with autism spectrum disorders

作　　者：李珂[1,2] 季忆婷[1,2] 江晓东 李斐[2,4] Li Ke;Ji Yiting;Jiang Xiaodong;Li Fei(Department of Developmental Behavioral Pediatrics,Shanghai Children′s Medical Center,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China;MOE-Shanghai Key Laboratory of Children′s Environmental Health,Shanghai 200092,China;Department of Children Healthcare,Children′s Hospital of Chongqing Medical University,Chongqing 400014,China;Department of Developmental Behavioral Pediatrics and Children Healthcare,Shanghai Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200092,China)

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,200127 [2]教育部和上海市环境与儿童健康重点实验室,上海200092 [3]重庆医科大学附属儿童医院儿保科,400014 [4]上海交通大学医学院附属新华医院发育行为儿保科,200092

出　　处：《中华实用儿科临床杂志》2019年第10期768-772,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：上海交通大学医学院高峰高原计划研究型医师项目(20152234).

摘　　要：目的探索我国孤独症谱系障碍(ASD)患儿中胃肠问题与ASD症状表现间的关系,以期为ASD患儿的干预提供线索。方法根据纳入和排除标准,纳入3~8岁ASD患儿336例。由父母或照养人填写患儿一般资料,包括出生年月、性别、既往食物过敏史、近3个月胃肠问题现况及本研究使用的社会心理学相关量表。分析胃肠问题与ASD症状表现(重复刻板行为、感觉反应异常、情绪及行为问题)间的关联。结果本研究336例ASD患儿中,胃肠问题阳性85例,检出率25.3%。同胃肠问题阴性组相比,胃肠问题阳性组的感觉高反应性(t=3.172,P<0.05)和情绪问题(t=-3.215,P<0.05)更严重。进一步的回归分析显示,胃肠问题与感觉高反应性[β(SE)=-0.041,P<0.05,Exp(β)=-0.959]、情绪问题[β(SE)=0.375,P<0.05,Exp(β)=1.456]显著相关。特定的、有无呕吐与感觉高反应性显著相关(B=-14.446,P<0.05),有无便秘与情绪问题得分显著相关(B=1.555,P<0.05)。结论胃肠问题在我国ASD患儿中较常见,且与感觉高反应性和情绪问题显著相关,提示解决胃肠问题可能对ASD患儿合并的感觉与情绪问题有缓解作用。Objective To explore the association between gastrointestinal problems and autism spectrum disorders(ASD) related symptoms, in order to give some clues to the management of ASD children. Methods Three hundred and thirty-six ASD children aged from 3-8 years old were recruited for the study according to the inclusion and exclusion criteria.General information about the children, including birth date, gender, food allergy history, gastrointestinal problems in the recent 3 months and social psychological scales, were completed by parents or caretakers.The association between gastrointestinal problems and ASD related symptoms (repetitive and stereotypic behaviors, sensory processing problems, emotional and behavioral problems) were analyzed. Results Among 336 ASD individuals, gastrointestinal problems were detected in 85 children.General gastrointestinal problem detection rate was 25.3%.ASD children with gastrointestinal problems were more severe in sensory over responsitivity(t=3.172, P<0.05), as well as emotional problems(t=-3.215, P<0.05). According to the regression analysis, gastrointestinal problem was significantly associated with sensory over responsitivity[β(SE)=-0.041, P<0.05, Exp(β)=-0.959], as well as emotional problems[β(SE)=0.375, P<0.05, Exp(β)=1.456]. Specifically, vomit was significantly associated with sensory over responsitivity(B=-14.446, P<0.05), and constipation was significantly associated with emotional problems(B=1.555, P<0.05). Conclusions Gastrointestinal problems are often seen in Chinese ASD children.Gas-trointestinal problems are significantly associated with sensory over responsitivity, as well as emotional problems, implying that resolving gastrointestinal problems may be helpful to remit these problems.

关 键 词：孤独症谱系障碍 胃肠问题 感觉高反应性 情绪问题 

分 类 号：R749.94[医药卫生—神经病学与精神病学]