改良婴幼儿孤独症量表中文简化版在3~4岁儿童中的应用分析  

Application analysis of the Chinese simplified version of M-CHAT in children aged 3 to 4 years

作　　者：陈强[1] 袁滨 徐文娟[1] 戚小兵[1] 杨丽勇 齐洋洋 CHEN Qiang;YUAN Bin;XU Wen-juan;QI Xiao-bing;YANG Li-yong;QI Yang-yang(Zhuhai Maternal and Child Health Hospital,Zhuhai,Guangdong 519001,China;The Third Hospital of Fuzhou City,Fuzhou,Jiangxi 344000,China;Jinding Community Health Service Center,Zhuhai High Tech Industrial Development Zone,Zhuhai,Guangdong 519008,China;Wuzhou Kindergarten of Xiangzhou District,Zhuhai,Guangdong 519000,China)

机构地区：[1]珠海市妇幼保健院,广东珠海519001 [2]抚州市第三医院,江西抚州344000 [3]珠海高新技术产业开发区金鼎社区卫生服务中心,广东珠海519008 [4]珠海市香洲区五洲幼儿园,广东珠海519000

出　　处：《中国儿童保健杂志》2020年第5期571-574,共4页Chinese Journal of Child Health Care

基　　金：广东省医学科学技术研究基金(B2018141)。

摘　　要：目的探索改良婴幼儿孤独症量表中文简化版(M-CHAT中文简化版)在3~4岁儿童中筛查孤独症谱系障碍(ASD)的应用价值,并制定合适界值。方法在2018年1-12月期间,选取年龄在3~4岁之间临床诊断为ASD儿童48例及正常发育儿童96名为研究对象,对其分别进行M-CHAT中文简化版评定,并绘制ROC曲线,以评价该量表在3~4岁儿童中筛查ASD的价值。结果 M-CHAT中文简化版在3~4岁儿童中筛查ASD时,其ROC曲线下面积AUC为0.94(95%CI:0.893~0.975);当筛查界限分为13分时,M-CHAT中文简化版区别ASD和非ASD能力最高,其灵敏度为0.94(95%CI:0.828~0.987)、特异度为0.82(95%CI:0.732~0.893)、Youden指数为0.76、阳性概率比5.29(95%CI:3.400~8.200)、阴性概率比0.08(95%CI:0.030~0.200)、阳性预测值为72.58%、阴性预测值为96.34%。结论 M-CHAT中文简化版筛查3~4岁ASD儿童能力较强,值得在3~4岁年龄段儿童ASD筛查工作中推广应用。Objective To explore the application value of Chinese simplified version of M-CHAT to screen autism spectrum disorder(ASD) in children aged 3 to 4 years,and to establish appropriate thresholds. Methods A total of 48 ASD children aged 3 to 4 years and 96 normal developing children were selected as subjects from January 2018 to December 2018.The Chinese simplified version of M-CHAT was used and ROC curve was drawn to evaluate the value of the scale in screening ASD among children aged 3 to 4 years. Results Using the Chinese simplified version of M-CHAT in screening ASD in children aged 3 to 4 years old,the area under the curve(AUC) was 0.94(95%CI:0.893―0.975).When the cutoff point was divided into 13,the Chinese simplified version of M-CHAT showed the highest ability to distinguish ASD from non-ASD.Its sensitivity was 0.94(95% CI:0.828―0.987),specificity was 0.82(95% CI:0.732―0.893),Youden index was 0.76,positive probability ratio was 5.29(95% CI:3.400-8.200) and negative probability ratio was 0.08(95% CI:0.030―0.200).The positive predictive value was 72.58% and the negative predictive value was 96.34%. Conclusion The Chinese simplified version of M-CHAT shows strong ability to screen ASD children aged 3 to 4 years,and is well worth popularizing and applying in ASD screening for children aged 3 to 4 years.

关 键 词：孤独症 M-CHAT中文简化版 儿童 

分 类 号：R749.91[医药卫生—神经病学与精神病学]