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中国循证儿科杂志

中国循证儿科杂志 ›› 2020, Vol. 15 ›› Issue (3): 220-223.

• 论著 • 上一篇    下一篇

孤独症谱系障碍儿童体格生长状况的横断面调查

李慧萍，徐琼，胡梅新，李冬蕴，董萍，张颖，徐秀   

  1. 复旦大学附属儿科医院儿童保健科 上海，201102
  • 收稿日期:2020-03-19 修回日期:2020-04-16 出版日期:2020-06-25 发布日期:2020-06-25
  • 通讯作者: 徐秀

Growth status of children with autism spectrum disorder: A cross-sectional study

LI Hui-ping, XU Qiong, HU Mei-xin, LI Dong-yun, DONG Ping, ZHANG Ying, XU Xiu   

  1. Department of Child Healthcare, Children's Hospital of Fudan Universtiy, Shanghai 201102, China
  • Received:2020-03-19 Revised:2020-04-16 Online:2020-06-25 Published:2020-06-25
  • Contact: XU Xiu

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摘要： 目的：探讨孤独症谱系障碍(ASD)儿童体格生长偏离状况。方法：本文数据来自于2016年1月至2019年8月在复旦大学附属儿科医院有资质的发育行为专科医生诊断的ASD专科病历数据库，采集在疑似（<2岁）和诊断ASD时常规体格测量等检查数据，疑似ASD的幼儿随访到2岁后诊断。体格测量结果依据WHO儿童体格参考标准转化为年龄相应的体重、身长/身高、BMI的Z值,用于体格生长状况评价。BMI Z值>+2 SD为肥胖、<-2 SD为消瘦，肥胖和消瘦统称为生长偏离。并行生长偏离影响因素分析。结果：ASD专科病历数据库511例连续样本进入本文分析， 1~4岁420例（82.2%），~8岁91例（17.8%）；男431例，女80例。总体ASD人群及1~4岁肥胖比例高于消瘦，差异有统计学意义；~8岁ASD人群肥胖与消瘦比例差异无统计学意义；ASD男女童肥胖、消瘦比例差异无统计学意义。~8岁ASD人群生长偏离和消瘦发生率分别是1~4岁的3.3倍（95%CI: 1.81~6.00）和5.64倍（95%CI: 2.22~14.31）。总体和1~4岁ASD人群相比，体重、身长/身高和BMI的Z值分布曲线较WHO儿童参考标准Z值正态分布参考线右移，向肥胖偏离；~8岁ASD人群BMI的Z值分布曲线峰值低，体型匀称比例下降，向+2 SD和-2 SD外延伸，向肥胖、消瘦偏离。结论：ASD儿童人群生长偏离既有肥胖也有消瘦，ASD学龄期儿童人群生长偏离发生率高于学龄前期儿童人群，且体型匀称比例下降，向肥胖和消瘦偏离。

Abstract: Objective:To investigate the deviation of physical growth status of children with autism spectrum disorder (ASD). Methods:Data were collected from the specialty medical record database of ASD diagnosed by qualified developmental behavior specialists from Children's Hospital of Fudan University from January 2016 to August 2019. The data were collected from routine physical measurement at the time of suspicion for (<2 years old) and diagnosis of ASD. Children with suspected ASD were followed up to be diagnosed at the age of 2. Anthropometric parameters (weight, length/height, BMI) were converted to Z-scores for age using the WHO Anthro. BMI Z-score > +2 SD refers to obesity, and BMI Z-score < -2 SD refers to emaciation. Obesity and emaciation together are defined as deviation. Influencing factors of physical growth deviation were analyzed. Results:A total of 511 consecutive ASD samples from the ASD medical record database were analyzed, including 420 cases (82.2%) aged 1 to 4 and 91 cases (17.8%) aged 5 to 8. There were 431 males and 80 females. The proportion of obesity in all included ASD patients and the group of 1-4 years old was higher than that of emaciation (P<0.05). There was no significant difference between the ratio of obesity and emaciation in the group of 5-8 years old. There was no significant difference in obesity and emaciation ratio between boys and girls with ASD. The incidences of growth deviation and emaciation in the group of 5-8 years old were 3.3 times (95%CI: 1.81-6.00) and 5.64 times (95%CI: 2.22-14.31) higher than that in the group of 1-4 years old. Compared with the group of 1-4 years old , the Z-score distribution curves of weight, length/height and BMI shifted to the right for all included ASD patients against the reference line of Z-score normal distribution, showing a trend of obesity. The distribution curve of BMI Z-score in ASD children aged 5-8 years had a low peak, and the proportion of body symmetry decreased. It extended to over ±2 SD, and deviated to obese and wasted growth status. Conclusion:The deviation of physical growth status of children with ASD included both obesity and emaciation. School-age children with ASD had a higher incidence of physical growth deviation, a lower ratio of fit-shape figure, and deviated to obesity and emaciation.