孤独症谱系障碍患儿婴儿期体格、神经心理发育及脑干听觉诱发电位特征

Characteristics of infant physical and neuropsychological development and brainstem auditory evoked potential in children with autism spectrum disorder

目的:探讨孤独症谱系障碍(ASD)患儿婴儿期体格、神经心理发育及脑干听觉诱发电位(BAEP)特征。方法:收集21例2~6岁ASD患儿(ASD组)在其1、3、6及12月龄时体格发育资料(体质量、身长和头围)、神经心理发育评估资料[包括智力发展指数(MDI)和精神运动发展指数(PDI)]及BAEP检测结果(包括Ⅰ、Ⅲ、Ⅴ波潜伏期及I-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ峰间期),并与63名同龄正常儿童(对照组)比较。结果:两组婴儿期各月龄体格发育水平比较差异无统计学意义(P>0.05)。神经心理发育评估显示,12月龄时ASD组MDI和PDI明显低于对照组(P均<0.01)。BAEP检测结果显示,1及3月龄时ASD组BAEPⅠ波、Ⅲ波、Ⅴ波潜伏期、Ⅰ-Ⅲ峰间期、Ⅲ-Ⅴ峰间期及Ⅰ-Ⅴ峰间期明显长于对照组(P<0.05或P<0.01)。ASD组异常频率最多的是V波潜伏期延长(47.2%)。结论:婴儿期早期(1~3月龄)持续V波潜伏期延长、12月龄时神经心理发育迟缓可能为ASD患儿早期特征性改变,可作为ASD早期预警指标之一。

Objective:To investigate the characteristics of infant physical and neuropsychological development and brainstem auditory evoked potential(BAEP)in children with autism spectrum disorder(ASD).Method:The physical development data(weight,height and head circumference),neuropsychological development assessment data[including mental development index(MDI)and phychomotor development index(PDI)]and BAEP test results(including the latency ofⅠwave,Ⅲwave,Ⅴwave,Ⅰ-Ⅲpeak interval,Ⅲ-Ⅴpeak interval andⅠ-Ⅴpeak interval)were collected from 21 children with ASD aged 2 to 6 years(ASD group)at 1,3,6 and 12 months,compared with 63 normal children of the same age(control group).Results:There was no significant difference in the physical development level between the two groups(P>0.05).Neuropsychological development assessment showed that MDI and PDI in the ASD group were significantly lower than those in the control group at 12 months of age(both P<0.01).At the age of 1 month and 3 month,the latency ofⅠwave,Ⅲwave,Ⅴwave,Ⅰ-Ⅲpeak interval,Ⅲ-Ⅴpeak interval andⅠ-Ⅴpeak interval of the ASD group were longer than those of the control group,with significant difference(P<0.05 or P<0.01).The most abnormal frequency in the ASD group was the prolonged latency of V wave(47.2%).Conclusion:Prolonged BAEP V wave latency in early infancy(1-3 months old)and neuropsychological developmental delay at 12 months old may be early characteristic changes in children with ASD,which may be helpful for the early diagnosis of ASD.