摘要:
探讨孤独症谱系障碍(ASD)儿童胃肠问题的发生情况及其与临床表型特征的关系,为ASD儿童的综合干预提供参考.方法 选取在哈尔滨医科大学儿童发育行为研究中心就诊及进行康复训练的ASD儿童110名及与其年龄、性别匹配的正常儿童110名,收集儿童胃肠道症状、情绪、睡眠等临床特征资料,比较儿童胃肠问题发生情况;采用孤独症诊断访谈量表修订版(ADI-R)对ASD儿童进行评估,分析有无胃肠问题的ASD儿童的ADI-R得分以及其他临床特征的组间差异.结果 ASD儿童胃肠问题总检出率(44.5%)高于正常儿童(24.5%)(x2=9.730,P<0.01);各类胃肠问题腹泻、腹胀、腹痛和便秘ASD组均高于对照组,在腹泻、腹胀方面差异均有统计学意义(X2值分别为6.62,6.74,P值均<0.05).与无胃肠问题的发生率ASD儿童相比较(3.83±2.29),伴有胃肠问题的ASD儿童ADI-R的重复刻板行为评分(5.30±2.55)明显增高(t=3.17,P<0.01);有无胃肠问题组ASD儿童在情绪和睡眠问题上检出率差异均有统计学意义(X2值分别为7.01,4.27,P值均<0.05).结论 ASD儿童的胃肠问题检出率较高,有胃肠问题的ASD儿童重复刻板行为症状较重,并影响儿童情绪和睡眠.在ASD儿童的干预过程中要关注儿童伴有的临床相关问题,进行综合治疗和管理.
Abstract:
Objective To explore the prevalence of gastrointestinal problems among children with autism spectrum disorder (ASD) and analyze the correlation between clinical features and gastrointestinal problems (GI) among children with ASD,and to provide reference for the comprehensive intervention of children with ASD.Methods 110 cases of ASD and 110 normal children were recruited,and the information about the gastrointestinal problems,emotional problems and sleep problems were collected.Autism diagnostic interview-revised (ADI-R) was used to assess ASD phenotype.Further,we compared the scores of ADI-R and the prevalence of clinical features between ASD with/without GI problems groups.Results The ASD children had a significantly higher prevalence of gastrointestinal problems than that in normal children (44.5% vs 24.5%)(X2 =9.730,P<0.01),especially in the symptoms of diarrhoea and abdominal distension (P<0.05).and the scores in diarrhea and abdominal distension are significantly different(X2 =6.62,6.74,P<0.05).Compared with 61 ASD students with no gastrointestinal problem (3.83±2.29),the "repetitive and stereotyped behavior" of 49 ASD students with gastrointestinal problem(5.30±2.55) get a higher score(t =3.17,P<0.01) Also,emotional problems and sleep problems were different between ASD with/without GI problems groups (X2 =7.01,4.27,P<0.05).Conclusion ASD children are more likely to have gastrointestinal problems compared with normal children.Compared to ASD children without GI problems,ASD children with GI problems are more serious in repetitive and stereotyped behaviors and more likely to have emotional and sleep problems.Therefore,it is necessary to pay more attention to related clinical problems of ASD,and carry out the comprehensive treatment and management of them.
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