孤独谱系障碍患儿消化道症状与行为表现关系分析

目的 分析孤独谱系障碍(ASD)患儿消化道症状的检出率及消化道症状与行为表现之间的关系,为ASD的干预治疗提供新的思路。方法 根据精神疾病诊断及统计手册第5版的诊断标准,选取2017年1月-2019年12月在江苏大学附属医院儿科儿童康复中心就诊的ASD患儿112例,选取正常儿童100例作为对照组。采用儿童孤独谱系障碍评定量表(CARS)、孤独谱系障碍儿童行为检查量表(ABC)对ASD患儿进行症状评估,采用Gesell发育量表(GDS)对ASD患儿进行发育评估,采用问卷调查儿童的消化道症状与行为表现。结果 ASD组消化道症状检出率显著高于对照组(72.3% vs.24.0%,χ²=33.012,P＜0.001)。将ASD患儿分为有消化道症状组(62例)和无消化道症状组(50例),两组间GDS、CARS和ABC评分比较差异无统计学意义(P>0.05);有消化道症状组情绪问题、行为问题(伤人/自伤)、重复刻板行为问题以及总评分明显高于无消化道症状组(t=4.868、4.101、4.812、5.968,P<0.001)。结论 ASD患儿消化道症状发生率明显高于正常儿童,有消化道症状比无消化道症状的ASD患儿具有更严重的情绪和行为问题,提示临床干预消化道症状可能对ASD患儿的康复有重要意义。

Analysis on the relationship between gastrointestinal symptoms and behavioral manifestations in children with autism spectrum disorder

Objective To investigate the detection rate of gastrointestinal symptoms,and to analyze the association between gastrointestinal symptoms and behavioral manifestations in children with autism spectrum disorder(ASD),so as to provide new ideas for the intervention of ASD. Methods A total of 112 ASD children diagnosed according to the fifth edition of Diagnostic and Statistical Manual for Mental Disorders and 100 normal controls in the Department of Pediatrics of the Affiliated Hospital of Jiangsu University were enrolled in this study from January 2017 to December 2019.Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) were used to assess the symptoms of autistic children,Gesell Development Scale (GDS) was used to evaluate the development of autistic children,and questionnaire was used to investigate the occurrence of gastrointestinal symptoms and behavior performance in children. Results The detection rate of gastrointestinal symptoms in ASD group was significantly higher than that in control group (72.3% vs.24.0%,χ²=33.012,P<0.001).ASD children were divided into the gastrointestinal symptoms group (n=62) and the gastrointestinal symptoms-free group (n=50).The differences of GDS,CARS and ABC between the two groups were not statistically significant (P>0.05).However,the score of emotional problems,behavioral problems,stereotypies or repetitive behaviors and the overall score in the gastrointestinal symptoms group were significantly higher than those in gastrointestinal symptoms-free group (t=4.868,4.101,4.812,5.968,P＜0.001). Conclusions The prevalence of gastrointestinal symptoms in ASD children is significantly higher than that in typical children.ASD children with gastrointestinal symptoms have more serious emotional and behavioral problems than children without gastrointestinal symptoms,indicating that clinical intervention of gastrointestinal symptoms may be of great significance to the rehabilitation of ASD children.