孤独症谱系障碍早期诊断的影响因素分析

目的 研究孤独症谱系障碍(ASD)早期诊断的影响因素,为相关政策及研究提供科学依据。方法 对207例于深圳市妇幼保健院确诊的6岁以下ASD儿童的带养人进行现场或电话调查。依据诊断月龄分为早期诊断组(n=48,23.19%)和非早期诊断组(n=159,76.81%),采用调查表、盖瑟尔发育诊断量表(GDDS)、婴儿-初中学生社会生活能力量表(S-M)进行评估,运用单因素分析和逐步Logistic回归探讨影响因素。结果 两组的早期筛查、主要带养人等11个变量有统计学差异(P<0.05)。进行早期筛查有利于早期诊断(OR=4.296,95%CI:1.959~9.423);生活能力水平(OR=0.380,95%CI:0.207~0.698)、粗大运动水平(OR=0.323,95%CI:0.185~0.564)越低,越不利于早期诊断。结论 早期筛查对早期诊断至关重要,应完善当前的ASD早期筛查程序。

Factors affecting the early diagnosis of autism spectrum disorders

Objective To investigate factors affecting the early diagnosis of autism spectrum disorders (ASD) in order to provide evidence for further research and policy. Methods Totally 207 ASD cases under six years old diagnosed at Shenzhen Maternity and Child Health care Hospital were recruited,and their caregivers were asked to finish a field survey or telephone survey.According to the diagnostic months,participants were divided into early diagnosis group(n=48,23.19%) and later diagnosis group(n=159,76.81%).Univariate analysis and stepwise Logistic regression analysis were used to compare the influencing factors on questionnaire,results of Gesell Development Diagnosis Scales (GDDS) and Baby-junior high school students ability of social life scale(S-M) between the two groups. Results The two groups were different in 11 factors,such as an early screening of ASD,the main caregivers.Multivarite Logistic analysis showed that early screening of ASD was an favorable factor(OR=4.296,95%CI:1.959~9.423).The more seriously disabled degree of ability for social life(OR=0.380,95%CI:0.207~0.698)and gross motor skill(OR=0.323,95%CI:0.185~0.564),the worse it was for early diagnosis. Conclusion Since the early screening plays a crucial role at early diagnosis,the process of early screening for ASD should be improved.