改良婴幼儿孤独症量表和婴幼儿孤独症量表-23在孤独症谱系障碍早期筛查中的临床适应性比较

A comparation study on modified checklist for autism in toddlers and checklist for autism in toddlers-23 for early screening of autism spectrum disorder

目的:比较改良婴幼儿孤独症量表(M-CHAT)和婴幼儿孤独症量表-23(CHAT-23)对孤独症谱系障碍(ASD)早期筛查的临床适用性。方法:分别采用M-CHAT和CHAT-23对符合《精神障碍诊断和统计手册》第5版(DSM-5)ASD诊断标准的54例18~30月龄的患儿(ASD组)及54名性别、年龄相匹配的正常儿童(对照组)进行评估和比较。结果:①ASD组:M-CHAT筛查阳性53例,阴性1例;CHAT-23筛查阳性50例,阴性4例;②对照组:M-CHAT筛查阳性3例,阴性51例;CHAT-23筛查阳性2例,阴性52例。ASD组M-CHAT与CHAT-23筛查灵敏度分别为98.1%及92.6%,特异度分别为94.4%及96.3%,两量表间差异无统计学意义;M-CHAT与CHAT-23筛查阳性率在18~24个月和25~30个月两个年龄组比较差异无统计学意义。结论:应用M-CHAT和CHAT-23进行ASD早期筛查均具有很高的灵敏度和特异度,并适合用于18~30个月龄的儿童。

Objective:To compare the clinical applicability of the modified checklist for autism in toddlers(M-CHAT)and checklist for autism in toddlers-23(CHAT-23)in the autism spectrum disorder(ASD).Method:Fifty-four aged 18 to 30 months ASD children(ASD group)who met ASD diagnostic criteria for Mental Disorders Diagnosis and Statistics Manual,5 th Edition(DSM-5)and 54 gender and age-matched normal children(control group)were evaluated by M-CHAT and CHAT-23,respectively.The screening results were compared.Results:In the ASD group,53 cases were positive and 1 case was negative by M-CHAT;and 50 cases were positive and 4 case were negative by CHAT-23.Meanwhile in the control group,3 cases were positive and 51 cases were negative by M-CHAT;and 2 cases were positive,52 cases were negative by CHAT-23.In the ASD group,the screening sensitivity of M-CHAT and CHAT-23 were 98.1%and 92.6%,respectively,and the screening specificity of M-CHAT and CHAT-23 were 94.4%and 96.3%.There was no significant difference between the two scales.The screening positive rates of M-CHAT and CHAT-23 between the subgroups of 18 to24 month age and 25 to 30 month age were not significantly different.Conclusion:The application of MCHAT and CHAT-23 for early ASD screening have high sensitivity and specificity and are suitable for children aged 18 to 30 months.