中国0~6岁儿童孤独症谱系障碍筛查患病现状

The prevalence of ASD screening in children aged 0-6 years old in China

目的了解中国0~6岁孤独症谱系障碍(ASD)的患病现状、分布情况及差异。方法选取2020年-2021年在中国山东省、湖北省、河北省3个省4家妇幼保健院和1家儿童医院儿保科参加健康体检的0~6岁儿童以及山东潍坊市安丘136家幼儿园3~5岁在园儿童为研究对象,共计89475例。首先采用预警征进行筛查,凡预警征筛查结果可疑,采用M-CHAT量表、ABC量表、克氏量表进一步筛查,筛查阳性儿童采用CARS量表和ADOS量表诊断,并综合经过统一培训且有临床工作经验的医师进行综合判断,最终确诊ASD。结果本次筛查研究ASD患病率为1.8%(95%CI:1.7%~2.0%);其中男童为2.6%(95%CI:2.4%~2.8%),女童为0.9%(95%CI:0.8%~1.0%),患病率性别比(男∶女)为2.9∶1;0~3岁儿童患病率为1.6%(95%CI:1.4%~1.7%),4~6岁儿童的患病率为2.5%(95%CI:2.2%~2.7%)。结论中国儿童ASD患病率较高,性别和年龄患病率存在差异。

Objective To investigate the prevalence,distribution and differences of autism spectrum disorders(ASD)children aged 0-6 years old in China.Methods A total of 89,475 children were selected from Shandong,Hubei,Hebei during 2020 to 2021,including children aged 0-6 who participated in health examination of 4 maternal and child health care hospitals and 1 pediatric care department of children′s hospital,and those aged 3-5 in 136 kindergartens of Anqiu,Weifang City,Shandong Province.Early warning signs were used for screening.If the results of early warning signs were suspicious,M-CHAT scale,ABC scale and CABS scale were used for further screening.The participants were diagnosed with autism if their positive results were further screened by CARS scale and ADOS scale,combined with the comprehensive judgment of doctors with unified training and clinical work experience.Results The prevalence of the participants was 1.8%(95%CI:1.7%-2.0%).The prevalence was 2.6%(95%CI:2.4-2.8)in boys,0.9%(95%CI:0.8%-1.0%)in girls,and the sex ratio was 2.9∶1.The prevalence in children aged 0-3 was 1.6%(95%CI:1.4%-1.7%),and that in children aged 4-6 was 2.5%(95%CI:2.2%-2.7%).Conclusion Chinese children had a high prevalence of ASD.There was statistical significance in the prevalence of ASD among children with different sex and age groups.