孤独症谱系障碍儿童胃肠问题与核心症状及预后的相关分析

Correlation study of gastrointestinal problems,core symptoms and prognosis in children with autism spectrum disorder

目的旨在探讨孤独症谱系障碍(ASD)儿童胃肠问题与临床核心症状及预后的关系,为ASD的诊断和预后提供线索。方法纳入98例ASD儿童(ASD组)和103例发育正常的健康儿童(HC组)。评估两组儿童是否存在胃肠问题;ASD组根据是否存在胃肠问题分为胃肠道阳性组(GI+组)和胃肠道阴性组(GI-组),分别予以儿童孤独症评定量表(CARS)、孤独症儿童行为检查量表(ABC)评估患儿核心症状。经过行为康复治疗后,再次给予GI+组儿童以上量表进行评估。结果 ASD组胃肠问题的发生率明显高于HC组(P<0.05);GI+组和GI-组CARS量表评分差异有统计学意义(P=0.005);胃肠症状好转的患儿治疗后儿童孤独症评定量表评分显著低于无好转者,也显著低于治疗前儿童孤独症评定量表评分(P<0.05);胃肠症状加重时患儿精神症状多加重。结论 ASD组胃肠问题发生率较高,积极干预胃肠道症状可能有利于ASD的治疗,且胃肠道症状可作为预测ASD儿童病情变化的一个指标。

Objective This study aims to explore the relationship between gastrointestinal problems and clinical core symptoms and prognosis of children with Autism spectrum disorder,so as to provide clues for the diagnosis,treatment and prognosis of ASD.Methods 98 of children with ASD(ASD group)and 103 of healthy children(HC group)were enrolled in the group,and gastrointestinal problems were assessed.ASD group was divided into gastrointestinal positive group(GI+group)and gastrointestinal negative group(GI-group)according to whether there were gastrointestinal problems.The core symptoms of ASD children were assessed by CARS and ABC respectively.After the behavioral rehabilitation therapy,the children with positive gastrointestinal symptoms were given the above scale again,and the correlation between the changes of gastrointestinal problems and their core symptoms and prognosis was statistically analyzed.Results The incidence of gastrointestinal problems in ASD group was significantly higher than that in HC group(P<0.05).The scores of CARS in GI+group and GI-group were statistically significant.The CARS score of the children with improved gastrointestinal symptoms after treatment was significantly lower than that of the children without improved gastrointestinal symptoms,and was also significantly lower than that before treatment(P<0.05).When gastrointestinal symptoms were aggravated,most of the’children’s mental symptoms were also aggravated.Conclusion The incidence of gastrointestinal problems in ASD group was higher than that in HC group;Active intervention of gastrointestinal symptoms may be beneficial to the treatment of ASD,and gastrointestinal symptoms can be used as an indicator to predict the changes of ASD childrenundefineds condition.