清远市清城区2~6岁孤独症谱系障碍的现状调查及相关因素分析(1)
【摘要】 目的：探究清遠市清城区2～6岁孤独症谱系障碍(ASD)儿童的患病率现状，并分析其相关因素。方法：选择2018年7月-2019年6月来本院儿童生长发育科、儿童心理卫生科就诊，以及在清远市清城区所辖幼儿园就读的2～6岁的儿童开展横断面调查，对该区域的儿童发放调查问卷4 700份，回收有效问卷4 512份，其中男2 564例，女1 948例。使用儿童孤独症行为检查量表(ABC)进行初次筛选，总分≥53分提示存在可疑孤独症样症状，≥67分明确存在孤独症样症状，再由本院儿童心理卫生专科医师参照美国精神疾病诊断统计手册第五版(DSM-5)的诊断标准明确诊断，计算其患病率，并通过单因素及多因素logistic回归方程分析两组患儿父母亲文化程度、家庭月收入、父母亲生育年龄、家族精神病史、父母的养育方式、1岁内户外活动时间、新生儿窒息、早产、住址、民族等相关因素，评估影响ASD的危险因素。结果：经调查，4 512例儿童中有105例为可疑，筛查阳性率为2.33%，而确诊为ASD的儿童有49例，其患病率为1.09%，其中男41例，占83.67%，而女8例，占16.33%，男女比例为5.13∶1。单因素分析显示，ASD组与对照组的性别、年龄、住址、1岁内户外活动时间、有意识说话出现的月龄、独立行走出现的月龄、父亲性格、父亲年龄、母亲年龄、父亲生育年龄、母亲生育年龄、父亲文化程度、母亲文化程度、养育方式、家庭月收入、家族精神病史、新生儿黄疸、新生儿窒息比较，差异均有统计学意义(P<0.05);而两组的民族、母亲性格、早产、先兆流产、剖宫产、母亲月经初潮年龄比较，差异均无统计学意义(P>0.05)。多因素logistic回归分析结果显示，男、1岁内户外活动时间<1 h、父亲性格内向、父亲年龄≥35岁、母亲年龄≥35岁、母亲生育年龄≥35岁、父亲文化程度初中及以下、家庭月收入≤1 999元、新生儿黄疸、新生儿窒息属于ASD的独立危险因素(P<0.05)，而独立行走出现的月龄≤12个月、养育方式民主型属于ASD的保护因素(P<0.05)。结论：男、1岁内户外活动时间<1 h、父亲性格内向、父亲年龄≥35岁、母亲年龄≥35岁、母亲生育年龄≥35岁、父亲文化程度初中及以下、家庭月收入≤1 999元、新生儿黄疸、新生儿窒息等12项指标均属于ASD的独立危险因素，而独立行走出现的月龄≤12月、养育方式民主型属于ASD的保护因素。
【关键词】 孤独症谱系障碍 现状调查 儿童
[Abstract] Objective： To investigate the prevalence of autism spectrum disorder (ASD) among children aged 2-6 years in Qingcheng District， Qingyuan City， and analyze its related factors. Method： A cross-sectional survey was conducted on children aged 2 to 6 who visited the Department of Child Growth and Development and the Department of Child Mental Health of our hospital from July 2018 to June 2019， as well as children studying in kindergartens under the jurisdiction of Qingcheng District， Qingyuan City， a total of 4 700 questionnaires were distributed to children in this area， and 4 512 valid questionnaires were collected， including 2 564 males and 1 948 females. Use of childhood autism behavior scale (ABC) for primary screening examination， a total of 53 or indicates there were suspicious of autistic symptoms， 67 points or more clear existence of autistic symptoms， again by the children’s mental health specialist reference to American psychiatric diagnostic statistical manual fifth edition (DSM-5) diagnostic criteria for diagnosis， calculating the prevalence， moreover， univariate and multivariate logistic regression equations were used to analyze the relevant factors such as the parents’ education level， family monthly income， parents’ child-bearing age， family history of mental illness， parents’ parenting style， time spent in and out of the home at the age of 1， asphyxia， preterm birth， address， ethnicity and so on in the two groups， to evaluate the risk factors affecting ASD. Result： According to the investigation， 105 of the 4 512 children were suspicious， with a positive screening rate of 2.33%. However， 49 children were diagnosed with ASD， with a prevalence rate of 1.09%， including 41 males (83.67%) and 8 females (16.33%)， with a male-female ratio of 5.13：1. Single factor analysis showed that the ASD group and the control group of gender， age， address， outdoor activities within one year of age time， consciously speak in months， the months of independent walking， father character childbearing age， age of the father， mother， father， mother birth age， father’s cultural level， cultural level， mother’s age at menarche， parenting style， family income， family history of mental illness， neonatal jaundice， neonatal asphyxia， the differences had statistical significance (P<0.05); however， there were no statistically significant differences between the two groups in ethnicity， maternal personality， premature delivery， threatened abortion and cesarean section (P>0.05). Multiariable logistic regression analysis showed， male gender， outdoor activity time within 1 year old<1 h， father’s introverted personality， father’s age ≥35 years old， mother’s age ≥35 years old， mother’s childbearing age≥35 years old， father’s education level of junior high school and below， monthly family income ≤ 1 999 yuan， neonatal jaundice and neonatal asphyxia were all independent risk factors for ASD (P<0.05)， while the month age of walking independently≤12 months and democratic type of parenting style were the protective factors for ASD (P<0.05). Conclusion： Male gender， outdoor activity time within 1 year old<1 h， father’s introverted personality， father’s age ≥35 years old， mother’s age ≥35 years old， mother’ s childbearing age≥35 years old， father’s education level of junior high school and below， monthly family income≤1 999 yuan， neonatal jaundice and neonatal asphyxia are all independent risk factors for ASD， while the month age of walking independently≤12 months and democratic type of parenting style are the protective factors for ASD., 百拇医药(沈锦红 吴文华 罗炼 黄肖霞)
【关键词】 孤独症谱系障碍 现状调查 儿童
[Abstract] Objective： To investigate the prevalence of autism spectrum disorder (ASD) among children aged 2-6 years in Qingcheng District， Qingyuan City， and analyze its related factors. Method： A cross-sectional survey was conducted on children aged 2 to 6 who visited the Department of Child Growth and Development and the Department of Child Mental Health of our hospital from July 2018 to June 2019， as well as children studying in kindergartens under the jurisdiction of Qingcheng District， Qingyuan City， a total of 4 700 questionnaires were distributed to children in this area， and 4 512 valid questionnaires were collected， including 2 564 males and 1 948 females. Use of childhood autism behavior scale (ABC) for primary screening examination， a total of 53 or indicates there were suspicious of autistic symptoms， 67 points or more clear existence of autistic symptoms， again by the children’s mental health specialist reference to American psychiatric diagnostic statistical manual fifth edition (DSM-5) diagnostic criteria for diagnosis， calculating the prevalence， moreover， univariate and multivariate logistic regression equations were used to analyze the relevant factors such as the parents’ education level， family monthly income， parents’ child-bearing age， family history of mental illness， parents’ parenting style， time spent in and out of the home at the age of 1， asphyxia， preterm birth， address， ethnicity and so on in the two groups， to evaluate the risk factors affecting ASD. Result： According to the investigation， 105 of the 4 512 children were suspicious， with a positive screening rate of 2.33%. However， 49 children were diagnosed with ASD， with a prevalence rate of 1.09%， including 41 males (83.67%) and 8 females (16.33%)， with a male-female ratio of 5.13：1. Single factor analysis showed that the ASD group and the control group of gender， age， address， outdoor activities within one year of age time， consciously speak in months， the months of independent walking， father character childbearing age， age of the father， mother， father， mother birth age， father’s cultural level， cultural level， mother’s age at menarche， parenting style， family income， family history of mental illness， neonatal jaundice， neonatal asphyxia， the differences had statistical significance (P<0.05); however， there were no statistically significant differences between the two groups in ethnicity， maternal personality， premature delivery， threatened abortion and cesarean section (P>0.05). Multiariable logistic regression analysis showed， male gender， outdoor activity time within 1 year old<1 h， father’s introverted personality， father’s age ≥35 years old， mother’s age ≥35 years old， mother’s childbearing age≥35 years old， father’s education level of junior high school and below， monthly family income ≤ 1 999 yuan， neonatal jaundice and neonatal asphyxia were all independent risk factors for ASD (P<0.05)， while the month age of walking independently≤12 months and democratic type of parenting style were the protective factors for ASD (P<0.05). Conclusion： Male gender， outdoor activity time within 1 year old<1 h， father’s introverted personality， father’s age ≥35 years old， mother’s age ≥35 years old， mother’ s childbearing age≥35 years old， father’s education level of junior high school and below， monthly family income≤1 999 yuan， neonatal jaundice and neonatal asphyxia are all independent risk factors for ASD， while the month age of walking independently≤12 months and democratic type of parenting style are the protective factors for ASD., 百拇医药(沈锦红 吴文华 罗炼 黄肖霞)