孤独症儿童胃肠道症状影响因素横断面研究  

Influencing factors of gastrointestinal symptoms in children with autism spectrum disorders: a cross-sectional study

作　　者：梁卉薇 成三梅[2] 汪芳 陈华兵 岑超群[2] 陈碧媛[2] LIANG Huiwei;CHENG Sanmei;WANG Fang;CHEN Huabing;CEN Chaoqun;CHEN Biyuan(Guangzhou Huiai Hospital,Guangzhou 510370,China;不详)

机构地区：[1]广州市惠爱医院(广州医科大学附属脑科医院),广州510370 [2]中山大学附属第三医院

出　　处：《中国神经精神疾病杂志》2019年第11期652-656,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：广东省省级科技计划项目（编号：20160914）

摘　　要：目的探讨孤独症儿童出现胃肠道症状及饮食、睡眠问题的情况,以及分析母乳喂养和出生方式等多种因素对孤独症合并胃肠道症状的影响。方法本研究为横断面调查,纳入2~10岁孤独症谱系障碍(autism spectrum disorders,ASD)患儿92例,并按照年龄匹配纳入典型发育(typical developing,TD)儿童84名为对照组,采用6项胃肠道症状严重程度指数量表(six gastrointestinal severity index,6-GSI)调查胃肠道症状,并采用自编问卷调查饮食偏好、睡眠问题及母乳喂养情况。结果ASD组6-GSI中便秘症状得分高于对照组(P<0.01)。分层分析显示,在ASD组中,剖宫产出生者胃肠道症状总分(P=0.030)、大便气味异常(P=0.028)及腹痛(P=0.022)得分高于经阴道生产者;而在对照儿童中,只有腹痛评分是剖宫产组高于经阴道产组(P=0.016)。ASD组中,有偏食与无偏食习惯的患儿比较,6-GSI中大便不成形(P=0.048)和腹痛(P=0.013)症状评分均有统计学差异。有睡眠异常与无睡眠异常的患儿比较,6-GSI中便秘(P=0.008)、大便不成形(P=0.020)和气味异常(P=0.027)症状得分有统计学差异。所有受试者以1岁前是否母乳喂养为主分组,6-GSI中便秘症状评分在组间有统计学差异(P=0.026)。结论孤独症儿童便秘症状的严重程度高于对照组,合并挑食或睡眠异常者出现更多的胃肠道不适,而母乳喂养可能减少其胃肠道症状。Objective To investigate the effect of multiple factors,including breast-feeding and modes of birth,on gastrointestinal(GI)symptoms of children with autism spectrum disorder(ASD).Methods This was a cross-sectional study.A total of 92 children,aged 2 to 10 years,with a diagnosis of ASD by DSM-5 criteria,along with 84 age-matched typical developing(TD)children as control,were enrolled in this study.The six-item gastrointestinal symptom index(6-GSI)was used for symptomatic survey.The self-made questionnaires were used to collect information on dietary preferences,sleep problems and breast-feeding.Results Constipation from 6-GSI was higher in ASD group than in TD group(P<0.01).Stratified analysis revealed that total GI symptom scores(P=0.030),fecal odor(P=0.028)and abdominal pain(P=0.022)were higher in ASD children born by c-section than ASD children born vaginally whereas only abdominal pain was higher in TD children born by C-section than TD children born vaginally(P=0.016).ASD children with pick eating had higher scores in diarrhea(P=0.048)and abdominal pain(P=0.013)than those without.ASD children with sleep disorders had higher scores in constipation(P=0.008),diarrhea(P=0.020)and fecal odor(P=0.027)than those without.There was also a significant difference in constipation from 6-GSI between mainly breast-fed children and mainly formula-fed children among all subjects(P=0.026).Conclusion ASD children have more severe constipation than TD children.ASD children with pick eating or with sleep disorders tend to have more GI symptoms,including diarrhea,fecal odor,and abdominal pain,while breastfeeding can alleviate these symptoms.

关 键 词：孤独症谱系障碍 胃肠道症状 饮食习惯 母乳喂养 剖宫产 

分 类 号：R749.94[医药卫生—神经病学与精神病学]