发育筛查量表联合改良版婴幼儿孤独症筛查量表在孤独症早期筛查中的效果

Effect of the Developmental Screening Scale Combined with the Modified Infant Autism Screening Scale in the Early Screening of Autism

目的探讨发育筛查量表(DST)联合改良版婴幼儿孤独症筛查量表(M-CHAT)在孤独症早期筛查中的效果。方法选择2017年1月至2020年1月郑州市妇幼保健院收治的200例孤独症婴幼儿作为观察组,选择同期156例接受健康体检的婴幼儿作为对照组,以临床诊断为"金标准",通过M-CHAT、DST量表筛查孤独症,统计两组DST量表评分以及M-CHAT、DST量表筛查孤独症情况,分析M-CHAT联合DST量表筛查孤独症的效能。结果观察组的智商(MI)、发育商(DQ)评分均比对照组低(P<0.05)。以临床诊断为金标准,M-CHAT量表筛查孤独症患儿的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为89.50%、93.59%、91.29%、94.71%、87.43%;DST量表筛查孤独症患儿的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为90.00%、94.87%、92.13%、95.74%、88.10%。M-CHAT联合DST量表筛查孤独症患儿的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为97.50%、91.02%、94.66%、93.30%、96.60%。3组的灵敏度、阴性预测值比较,差异有统计学意义(P<0.05)。M-CHAT联合DST量表筛查孤独症患儿准确率均比DST量表(χ^(2)=3.098,P=0.078)、M-CHAT量表(χ^(2)=1.845,P=0.174)高。结论M-CHAT、DST量表用于婴幼儿孤独症筛查,均具有良好的筛查能力,且M-CHAT联合DST量表筛查能够提高婴幼儿孤独症筛查准确率,值得临床推广使用。

Objective To explore the effect of the developmental screening scale(DST)combined with the modified infant autism screening scale(M-CHAT)in the early screening of autism.Methods A total of 200 infants and young children with autism admitted to Zhengzhou Maternal and Child Health Hospital from January 2017 to January 2020 were selected as the observation group,and 156 infants and young children who underwent health examinations during the same period were selected as the control group,with clinical diagnosis as the"gold standard".The M-CHAT and DST scales were used to screen for autism,the results of M-CHAT and DST scales of the two groups were observed to screen for autism,and the efficacy of M-CHAT combined with DST scales in screening for autism was analyzed.Results The mental index(MI)and developmental quotient(DQ)scores of the observation group were lower than those of the control group(P<0.05).Taking clinical diagnosis as the gold standard,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the M-CHAT scale in screening children with autism were 89.50%,93.59%,91.29%,94.71%and 87.43%,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the DST scale in screening children with autism were 90.00%,94.87%,92.13%,95.74%and 88.10%,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of M-CHAT combined with DST scale in screening children with autism were 97.50%,91.02%,94.66%,93.30%and 96.60%.The sensitivity,negative predictive value of the three groups were compared,and the differences were statistically significant(P<0.05).The accuracy rate of M-CHAT combined with DST scale screening for children with autism was higher than that of DST scale(χ^(2)=3.098,P=0.078)and M-CHAT scale(χ^(2)=1.845,P=0.174).Conclusion Both M-CHAT and DST scales have good screening capabilities for infant autism screening,and M-CHAT combined with DST scale screening can improve the accuracy of infant autism screening,and it is worthy of clinical application.