儿童孤独症213例病例分析

目的：探讨孤独症的病因、发病机制和诊断。方法：对213例孤独症患儿进行生物学因素（妊娠史，出生史，家庭史，抽搐史）、家庭因素（父母性格，家庭教育情况），病历主诉和辅助检查（脑CT／MRI，EEG，BAEP、SPECT）的研究分析。结果：孤独症病例在生物学因素（妊娠史，出生史，家族史，抽搐史）上的异常情况十分普遍，病历主诉以语言发育障碍为主，脑部的CT／MRI，EEG，BAEP，SPECT辅助检查中，SPECT异常检出率高，主要表现为左侧大脑血流灌注降低，血流异常的部位主要是颞叶、额叶和边缘系统（海马回，扣带回等）。结论：妊娠史、出生史、家族史、抽搐史的异常和孤独症的发病有密切关系，以语言发育迟缓为主诉的儿童病例应考虑孤独症的可能。脑SPECT呈血流灌注降低，对诊断孤独症有一定帮助。

Analyse of 213 Cases of Autism Children

To explore the pathogeny,mechanism and diagnosis of Autism. Two hundred and thirteen cases of autism children were studied about biologic factors(pregnancy,birth,family,seizure),family factors,chief complaint and assistant examinations(CT/MRI,EEG,BAEP,SPECT). The abnormity in biologic factors(pregnancy,birth,family,seizure)was generally seen among the autism children and the language development disability was mainly the chief compliant.Among the assistant examinations,an especially high abnormality was found in SPECT.SPECT showed that autism children had a lower perfusion mainly in left brain,including temperal lobe,frontal lobe,limbic system(hippocampus,cingnlate gyrus et al). Conclusions] There was relationship between the abnormality of pergnancy,birth,family,seizure and the pathogeny of autism;the probability of autism should be paid attention to when the language development disability was the chief compliant;the lower perfusion of brain shown by SPECT was helpful to the diagnosis of autism.