郑州孤独症谱系障碍儿童营养状况

目的研究孤独症谱系障碍儿童营养状况,为改善孤独症谱系障碍儿童营养提供参考。方法选取2016年9月—2018年9月在郑州大学附属儿童医院收治的孤独症谱系障碍儿童120例(孤独症谱系障碍组),选择同期健康儿童120例(健康组)。采用克氏孤独症行为量表(Clancy Autism Behavior Scale,CABS)评估儿童状况,调查血清营养素及营养状况。结果与健康组比,孤独症谱系障碍组儿童维生素A[(83.44±9.20,59.45±4.42) mg/L]、维生素B6[(64.15±11.22,32.02±5.75) mg/L]、维生素C [(60.62±10.26,47.63±13.12) mg/L]、蛋白质[(120.45±30.51,104.46±9.38) g/L]、铁[(134.25±18.16,112.17±6.02) mg/L]、钙[(72.96±10.62,66.57±4.11) mg/L]、锌[(70.85±5.76,62.52±10.66) mg/L]、叶酸[(31.38±6.77,20.29±6.26) mg/L]、二十二碳五烯酸[(0.72±0.22,0.55±...     

孤独症谱系障碍儿童家长膳食营养知识知晓现状

了解孤独症谱系障碍(autism spectrum disorder,ASD)儿童家长膳食营养知识的知晓现状,为指导孤独症儿童的合理膳食提供依据.方法 选择2016年4-10月在哈尔滨医科大学儿童发育行为研究中心和某特教学校进行康复训练的3~16岁ASD儿童162名,按照性别和年龄匹配的原则,选择同地区小学和中学3~16岁正常儿童145名,采用自拟的家长膳食营养知识知晓情况调查问卷,对ASD儿童和正常儿童家长进行横断面问卷调查.结果 ASD组家长营养素基础知识、多不饱和脂肪酸(PUFAs)相关基础知识得分及膳食营养知识总分均低于对照组(P值均<0.05).ASD组家长总是给孩子补充二十二碳六烯酸(DHA)和从不补充DHA的比例均高于对照组(Z=-6.640,P<0.01).网络是2组儿童家长获得膳食营养相关知识的主要途径,但ASD组家长通过科普书籍获取营养知识的比例低于对照组(x2=5.161,P<0.05).结论 在ASD儿童日常康复训练的同时,有必要积极开展针对其家长的膳食及营养知识宣教活动,提高家长营养知识的知晓水平,尤其应加强ASD儿童家长对PUFAs相关知识的了解,促进ASD儿童的综合发展.     

孤独症儿童的营养状况调查

目的了解儿童孤独症患者膳食营养素摄入量与体格发育状况。方法采用连续3天24小时回顾法调查孤独症儿童膳食营养素摄入状况;测量其同期身高、体重,用Z评分法评价其营养状况。结果111名孤独症儿童中超重或肥胖占31．5％,急性或慢性营养不良占8．1％;该人群11种营养素摄入量不能满足其需要,尤其VA、VC、VB6、叶酸、钙和锌严重不足,尚不足推荐摄入量的60％,39．6％的患儿存在不同程度的营养素缺乏,其中钙、锌、叶酸、VB6的缺乏率达到88％以上。结论该人群营养过剩与营养缺乏并存,膳食营养素的摄入普遍不足,应采取相应措施改善其营养状况,促进其健康成长。     

孤独症谱系障碍儿童听觉特征分析

探讨孤独症谱系障碍(autism spectrum disorder,ASD)儿童听觉脑干反应(auditory brainstem response,ABR)各波潜伏期和峰间期的特征及与ASD行为表型间的关联.方法 收集哈尔滨市明确诊断的2~6岁ASD儿童90例,应用脑干电位诱发反应仪采集ABR数据,分析ASD儿童左右耳各波潜伏期、峰间期特征及与临床表型的关联.结果 ASD儿童左、右耳Ⅰ,Ⅲ,Ⅴ波潜伏期分别为(1.51±0.20)(3.83±0.34)(5.63±0.23)ms;(1.54±0.16)(3.78±0.23)(5.63±0.22)ms,均超过正常均值(P值均<0.05);ASD儿童Ⅰ-Ⅲ(6.6%),Ⅲ-Ⅴ(1.1%),Ⅰ-Ⅴ(3.3%)峰间期较正常儿童延长;<3岁组与3~7岁组ASD儿童相比,左右耳Ⅰ-Ⅲ,Ⅰ-Ⅴ峰间期均明显延长(P值均<0.05).关联性分析发现,ASD儿童左耳Ⅰ波潜伏期与孤独症诊断访谈量表修订版(ADI-R)社交功能缺陷存在正相关(r=0.45,P<0.05);左耳Ⅰ波潜伏期、Ⅲ-Ⅴ峰间期和右耳Ⅴ波潜伏期与非言语性沟通能力障碍呈正相关(r值分别为0.35,0.39,0.34,P值均<0.05);左、右耳Ⅰ-Ⅲ峰间期与重复刻板行为呈正相关(r值分别为0.39,0.35,P值均<0.05).结论 ASD儿童存在异常的听觉行为特征,且异常程度与ASD儿童社会交往、沟通及重复刻板行为的严重程度存在明显关联.     

孤独症谱系障碍儿童运动功能缺陷研究

<正>孤独症谱系障碍(autism spectrum disorder,ASD)是一组神经发育障碍性疾病^[1],核心症状包括两大方面:社交沟通障碍,狭隘、重复的兴趣或行为^[2]。ASD儿童的父母和临床医生常述ASD儿童运动水平低于同龄的典型发育(typical development,TD)儿童,主要表现为运动发育迟滞、姿势平衡障碍及异常运动模式^[3-6]。Ouellette-kuntz等^[4,7]分别报告了59%和79%ASD儿童存在运动功能缺陷,且进一步影响了他们的社交和日常生活。未经干预训练的ASD儿童运动功能缺陷可以持续至成年后,影响一生发展^[8]。     

天津市孤独症谱系障碍儿童社区康复效果评价

了解社区康复在孤独症谱系障碍儿童中的作用,探索康复效果的相关影响因素,为更好地改善患儿的相关缺陷提供依据.方法 采用克氏孤独症行为量表(CABS)和儿童孤独症行为量表(ABC)进行筛查,采用精神疾病诊断和统计手册(第5版)(DSM-V)及儿童孤独症评定量表(CARS)进行诊断,选取参加了天津市孤独症谱系障碍儿童社区康复项目的8所幼儿园已完成《孤独症儿童发展评估表》1年3次完整评估的19例孤独症谱系障碍儿童,年龄为24~ 82个月,对其家长进行调查并收集相关信息.采用重复测量方差分析及Pearson线性相关分析进行统计处理.结果 孤独症谱系障碍儿童的8个领域3次评估的得分,每一次较前一次都有不同程度提高(P值均 <0.05).随时间递进的3次评估的康复效果实际年龄与各领域发展年龄的差值呈下降趋势,差异均有统计学意义(P值均 <0.05),且康复手段越多元、越有针对性,效果越好.发现疑似症状的年龄、最终确诊的年龄、首发语言的年龄、能独立行走的年龄、CARS智力功能得分、CARS总分与康复效果在不同领域之间存在统计学意义的相关性(P值均<0.05).结论 天津市的社区康复对孤独症谱系障碍儿童的预后有积极作用,具有针对性的长期系统综合干预的效果显著.     

孤独症谱系障碍儿童体育干预研究进展

孤独症谱系障碍(autism spectrum disorder, ASD)儿童患病率的逐年攀升引发了公众对于此类人群健康问题的密切关注,该趋势强调了制定有效治疗方式的必要性。除常规康复治疗外,体育活动对于ASD儿童而言也是行之有效的干预方式。通过系统梳理“体育干预对ASD儿童影响”的相关文献,发现体育干预对ASD儿童的核心症状、运动技能、执行功能以及与以上症状相关的情绪、知觉等功能均有积极作用,可为ASD儿童运动康复研究提供理论支持和新思路。     

孤独症谱系障碍儿童饮食行为调查

了解孤独症谱系障碍(ASD)儿童的饮食行为,探讨改善ASD儿童饮食行为问题的方法,为指导ASD儿童的科学喂养提供依据.方法 病例组为来自青岛某医院和某孤独症康复训练学校的2~6岁ASD儿童128例,对照组为青岛市数家幼儿园正常儿童133名,采用自编的儿童饮食行为问卷调查比较两组儿童的10种饮食行为与10类食物的选择情况.结果 病例组每位ASD儿童出现饮食行为问题的总数是(5.9±1.9)个,高于对照组每位儿童的(4.7±2.4)个(Z=-4.068,P<0.05);ASD儿童进餐时离开饭桌的发生率为93.0%,需喂食的发生率为88.3%,吐食物的发生率为71.1%,扔食物的发生率为47.7%,尖叫的发生率为36.7%,而对照组儿童分别为73.7%,71.4%,58.6%,23.3%和17.3%,差异均有统计学意义(P值均<0.05).食物选择方面,病例组ASD儿童拒绝食用杂粮、豆类和鱼虾贝类的报告率均超过了30%,明显高于对照组(均不足20%);病例组儿童食用水果的报告率为89.8%,而对照组儿童均食用水果,两组间差异均有统计学意义(P值均<0.05).结论 ASD儿童普遍存在多种饮食行为问题,建议采取有效的干预措施进行矫正.     

孤独症谱系障碍儿童左侧视野优势效应研究

目的 探索孤独症谱系障碍儿童对面孔加工中左侧视野优势效应的损害情况,为加深理解孤独症社交损害的注意机制提供依据.方法 采取重复测量资料的混合设计,招募2016年9月—2019年12月在天津市各个孤独症康复机构训练的105名孤独症儿童,组成病例组,按照病例组的年龄和性别匹配正常发育的天津市小学或幼儿园就读的105名正常儿...     

黑龙江省孤独症谱系障碍儿童家庭经济负担现状

了解黑龙江省孤独症谱系障碍(autism spectrum disorder,ASD)儿童在就诊及康复治疗过程中的卫生费用支出情况及对家庭造成的经济负担,为相关部门制定帮扶政策提供依据.方法 采用自拟调查问卷对黑龙江省5个地市12所康复机构的314名ASD儿童的主要抚养人进行调查和访谈.结果 黑龙江省ASD儿童年均康复治疗总费用为6.44万,其中城镇为6.38万元,农村为6.53万元,差异无统计学意义(P>0.05).农村患儿交通膳食费用、房屋租住费用均高于城镇患儿(P值均<0.05).ASD儿童康复治疗总费用占家庭收入的平均比例为193.7%,其中城镇为173.9%,农村为219.6%,农村明显高于城镇(Z=-3.250,P<0.01).无论城乡,康复训练、交通膳食2项支出占收入(85.1%,98.2%;54.4%,79.9%)和支出(33.0%,32.4%;21.5%,26.7%)比例最大,其次为房屋租住、就诊和药物治疗.调查对象中有118名(37.6%)享受惠民补助.结论 ASD儿童康复治疗费用给患儿家庭造成严重的经济负担.应该进一步扩大本地区惠民补助的覆盖率、提高救助金额,最大限度减轻ASD患儿所带来的经济负担和精神压力.     

天津市3~7岁孤独症谱系障碍儿童体格发育和营养状况研究

目的 了解天津市3~7岁孤独症谱系障碍(ASD)儿童生长发育状况,为改善ASD儿童生长发育提供参考依据。方法 2016-2019年整群抽取天津市221名3~7岁ASD儿童进行体格测量,各项指标依据2015年中国九市7岁以下儿童体格发育和2008年WHO儿童生长发育标准转化为Z评分,以评价ASD儿童的体格和营养状况,采用儿童孤独症评定量表(CARS)评估ASD儿童症状严重程度。结果 天津市ASD儿童超重/肥胖率为19.0%,年龄别体重Z评分(WAZ)、年龄别身高Z评分(HAZ)、年龄别体重指数Z评分(BAZ)分布曲线向右偏移,胸围及腰围的Z评分分布曲线向+3s外延伸,坐高的Z评分分布曲线向左偏移,呈现生长偏离趋势。男童WAZ(Z=2.053,P<0.05)及超重/肥胖率(χ²=6.572,P<0.05)高于女童,6~7岁组超重/肥胖率高于3~岁和4~岁组(P<0.05),不同ASD症状严重程度间营养状况的差异无统计学意义(χ²=5.321,P>0.05)。结论 天津市ASD儿童超重/肥胖检出率较高,存在体格生长偏离,应加强ASD儿童生长发育监测和肥胖的早期干预。     

Dietary intake and nutritional status of children and adolescents in Europe

The objective of this project was to collect and evaluate data on nutrient intake and status across Europe and to ascertain whether any trends could be identified. Surveys of dietary intake and status were collected from across Europe by literature search and personal contact with country experts. Surveys that satisfied a defined set of criteria -- published, based on individual intakes, post-1987, adequate information provided to enable its quality to be assessed, small age bands, data for sexes separated above 12 years, sample size over 25 and subjects representative of the population -- were selected for further analysis. In a small number of cases, where no other data for a country were available or where status data were given, exceptions were made. Seventy-nine surveys from 23 countries were included, and from them data on energy, protein, fats, carbohydrates, alcohol, vitamins, minerals and trace elements were collected and tabulated. Data on energy, protein, total fat and carbohydrate were given in a large number of surveys, but information was very limited for some micronutrients. No surveys gave information on fluid intake and insufficient gave data on food patterns to be of value to this project. A variety of collection methods were used, there was no consistency in the ages of children surveyed or the age cut-off points, but most surveys gave data for males and females separately at all ages. Just under half of the surveys were nationally representative and most of the remainder were regional. Only a small number of local surveys could be included. Apart from anthropometric measurements, status data were collected in only seven countries. Males had higher energy intakes than females, energy intake increased with age but levelled off in adolescent girls. Intakes of other nutrients generally related to energy intakes. Some north-south geographical trends were noted in fat and carbohydrate intakes, but these were not apparent for other nutrients. Some other trends between countries were noted, but there were also wide variations within countries. A number of validation studies have shown that misreporting is a major problem in dietary surveys of children and adolescents and so all the dietary data collected for this project should be interpreted and evaluated with caution. In addition, dietary studies rely on food composition tables for the conversion of food intake data to estimated nutrient intakes and each country uses a different set of food composition data which differ in definitions, analytical methods, units and modes of expression. This can make comparisons between countries difficult and inaccurate. Methods of measuring food intake are not standardised across Europe and intake data are generally poor, so there are uncertainties over the true nutrient intakes of children and adolescents across Europe. There are insufficient data on status to be able to be able to draw any conclusions about the nutritional quality of the diets of European children and adolescents.     

Dietary intake and nutritional status in Italian elderly subjects

Dietary intake and nutritional status was assessed in a random sample of 190 Italians (70-75 years of age) participating in the Survey in Europe on Nutrition and the Elderly (EURONUT-SENECA). The daily energy intake as assessed by a Modified Dietary History, was 2208+/-562 Kcalories in men and 1742+/-527 Kcalories in women. The alcohol intake was significantly higher in men than in women (35. 9+/-32.5 g/day vs 14.7+/-15.4 g/day; p<0.0001). As for calcium, there was a high percentage of men (77%) and women (86%) with a lower intake than the recommended values. The subjects underweight (BMI<20) were only 4.1% men and 9.7% women, while the great part was normal (BMI= 20-24.9) and overweight (BMI=25-29.9). The body composition parameters showed a significant difference between two genders. Men had a Total Body Water (56.5+/-4.5% vs 51.3+/-5.4%; p<0. 001) and Fat-Free Mass (80.4+/-5.2% vs 70.9+/-6.8%; p<0.001) higher than women. Few subjects were at high risk of deficiency with regard to plasma levels of vitamins, haemoglobin and albumin. If we analyse the composition of the diet consumed, we can remark the characteristics of a typical Mediterranean diet. We conclude that the general nutritional status of our sample was fairly good.     

孤独症儿童膳食及营养状况的对比研究

目的 比较孤独症儿童与正常发育儿童的营养状况,以便临床能有效地进行监测和干预。 方法 募集孤独症儿童及正常发育儿童各53例,由家长完成受试儿童3 d的膳食记录评价膳食摄入情况,检测血清生化指标评价血清营养素水平,并进行体格检查评价其生长发育状况。 结果 两组儿童维生素A、维生素B6、锌和钙的摄入水平与我国该年龄段儿童的膳食营养素推荐摄入量相比较均<80%,表明我国儿童上述营养素普遍摄入不足;而维生素B1、B2和叶酸的摄入水平两组儿童均属于边缘不足(为该年龄段儿童膳食营养素推荐摄入量的81%~100%);孤独症儿童维生素C和钙摄入不足的人数明显高于对照组。两组儿童血清锌水平均低于正常参考范围,但差异无统计学意义;孤独症儿童血清钙和叶酸的水平明显低于正常发育儿童,且血清钙水平还低于正常参考值范围。孤独症儿童的ZWA、ZBMIA及BMI指数,及6岁以下孤独症儿童ZWH均明显高于正常发育儿童,但两组儿童生长问题的分布差异无统计学意义。 结论 孤独症儿童和正常发育儿童均存在营养缺乏情况,但孤独症儿童更为严重,特别是钙、锌、维生素C和叶酸的缺乏较正常发育儿童更为明显。     

孤独症谱系障碍儿童的语言发育特征

孤独症谱系障碍(ASD)是儿童期常见的发育障碍性疾病,致残率高.语言障碍是ASD儿童的最常见共患病,其早期识别、诊断和早期针对性的干预措施,对改善ASD的预后具有重要意义.本文就孤独症谱系障碍儿童的语言发育特征进行综述.     

儿童孤独症谱系障碍运动功能评定分析

目的 了解孤独症谱系障碍(ASD)患儿运动功能发育情况,为ASD患儿的精准干预提供临床证据。方法 回顾性分析2017年3月-2019年12月在贵州省人民医院发育行为专科就诊的182例2～6岁ASD患儿认知和运动评估结果。结果 运动评估显示,ASD患儿粗大运动商平均为(69.9±13.7)分,精细运动商平均为(75.2±15.5)分,总运动商平均为(70.1±13.8)分。78.0%(142/182)ASD患儿存在粗大运动落后、61.5%(112/182)精细运动落后、75.8%(138/182)总运动落后。ASD患儿运动能力与智力发育水平呈明显正相关(r＝0.018~0.672, P＜0.01),精细运动各维度与智力发育水平的相关性最高。ASD女性患儿精细运动抓握能力维度优于男性患儿(P＜0.05),3岁以上患儿精细运动抓握能力维度落后明显(P＜0.05)。结论 ASD患儿存在明显的运动发育落后。对ASD患儿应尽早进行运动评估,便于制定精准化临床干预。