目的 · 探索孤独症谱系障碍(ASD)儿童胃肠问题检出率及分布情况。方法 · 纳入在上海交通大学医学院附属上海儿童医学 中心及附属新华医院发育行为儿科就诊的 3 ~ 8 岁 ASD 患儿 336 名。所有患儿均符合《精神疾病诊断与统计手册》第 5 版诊断标准。 由父母或照养人填写患儿一般资料,包括出生年月、性别及近 3 个月胃肠问题现况等。探索胃肠问题在此人群中的检出率及分布情 况。结果 · 336 例 ASD 患儿中,胃肠问题阳性85 例,总体检出率25.3%。其中便秘 59 例(17.6%),呕吐 12 例(3.6%),腹泻 11 例 (3.3%),腹痛 7 例(2.1%),腹胀 6 例(1.8%)。在 3 ~ 8 岁合并胃肠问题的 ASD 儿童中,不同年龄组之间胃肠问题检出率的差异无 统计学意义(χ2=1.511,P=0.680),胃肠问题严重度的差异也无统计学意义(F=0.773,P=0.513)。结论 · 胃肠问题在ASD 儿童中较常 见,且在 3 ~ 8 岁年龄段持续存在,其严重度不随年龄增长而降低。提示 ASD 儿童胃肠问题,尤其是便秘,需作为慢病管理的一部 分,其评估和治疗值得临床关注。
Objective · To explore the detection rate of gastrointestinal problems in autism spectrum disorder (ASD) children. Methods · 336 ASD children aged from 3-8 years old in Department of Developmental and Behavioral Pediatrics in Shanghai Children’s Medical Center and Xinhua Hospital were recruited to the study according to the inclusion and exclusion criteria. All of the children met diagnostic criteria of ASD in Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. General information about the children, including birth date, gender and gastrointestinal problems during recent 3 months, were completed by parents or caretakers. The detection rate of gastrointestinal problems was depicted in this population. Results · Among 336 ASD individuals, gastrointestinal problems were detected in 85 children. General detection rate for gastrointestinal problems is 25.3%. Specifically, 59 (17.6%) children were with constipation, 12 (3.6%) children with vomiting, 11 (3.3%) children with diarrhea, 7 (2.1%) children with abdominal pain and 6 (1.8%) children with abdominal bloating. There was no significant difference in detection rate for gastrointestinal problems among different age groups (χ2=1.511, P=0.680), as well as in severity scores for gastrointestinal problems (F=0.773, P=0.513). Conclusion · Gastrointestinal problems are often found in Chinese ASD children and persistently occurred in children aged 3 to 8 years old, but the severity score for gastrointestinal problems did not significantly decrease as age increased. More concern must be paid to gastrointestinal problems, especially to constipation. Gastrointestinal problems should be taken as a part of chronic disease management in ASD children.