中国儿童保健杂志 ›› 2022, Vol. 30 ›› Issue (4): 355-360.DOI: 10.11852/zgetbjzz2021-0398

• 科研论著 • 上一篇    下一篇

孤独症谱系障碍儿童严重挑食与核心症状的关联

艾女湉1, 张倩1, 杨亭1, 陈洁1, 陈立1, 代英1, 贾飞勇2, 武丽杰3, 郝燕4, 李玲5, 张婕6, 柯晓燕7, 衣明纪8, 洪琦9, 陈津津10, 方拴锋11, 王益超12, 王琦13, 金春华14, 李廷玉1   

  1. 1.重庆医科大学附属儿童医院,儿童营养与健康重庆市重点实验室,儿童发育疾病研究教育部重点实验室,国家儿童健康与疾病临床医学研究中心,儿童发育重大疾病国家国际科技合作基地,重庆 400000;
    2.吉林大学第一医院;
    3.哈尔滨医科大学儿童发育行为研究中心;
    4.华中科技大学同济医学院附属同济医院;
    5.海南省妇女儿童医学中心;
    6.西安市儿童医院;
    7.南京医科大学附属脑科医院;
    8.青岛大学附属医院;
    9.深圳市宝安区妇幼保健院;
    10.上海市儿童医院;
    11.河南省儿童医院;
    12.湖南省妇幼保健院;
    13.德阳市妇幼保健院;
    14.首都儿科研究所附属儿童医院
  • 出版日期:2022-04-10 发布日期:2022-04-11
  • 通讯作者: 李廷玉,E-mail:tyli@vip.sina.com
  • 作者简介:艾女湉(1996-),女,重庆人,在读专业型研究生,主要研究方向为孤独症谱系障碍。
  • 基金资助:
    国家自然科学基金面上项目(81771223);科技基础资源调查专项(2017FY101100,子课题编号2017FY101103)

Association between picky eating and core symptoms in children with autism spectrum disorder

AI Nü-tian*, ZHANG Qian, YANG Ting, CHEN Jie, CHEN Li, DAI Ying, JIA Fei-yong, WU Li-jie, HAO Yan, LI Ling, ZHANG Jie, KE Xiao-yan, YI Ming-ji, HONG Qi, CHEN Jin-jin, FANG Shuan-feng, WANG Yi-chao, WANG Qi, JIN Chun-hua, LI Ting-yu   

  1. *Children's Hospital of Chongqing Medical University,Chongqing Key Laboratory of Child Health and Nutrition, Ministry of Education Key Laboratory of Child Development and Disorders,National Clinical Research Center for Child Health and Disorders,National International Science and Technology Cooperation Base for Critical Children's Development,Chongqing 400000,China
  • Online:2022-04-10 Published:2022-04-11
  • Contact: LI Ting-yu,E-mail:tyli@vip.sina.com

摘要: 目的 分析孤独症谱系障碍(ASD)儿童严重挑食与其核心症状之间的关联,为ASD儿童的早期识别和精准干预提供参考。方法 纳入2018年5月—2019年12月在全国13城市的13家医院招募的2~7岁1 349名ASD儿童,1 170名典型发育(TD)儿童;采用自制问卷调查挑食情况,采用孤独症行为量表(ABC)、社会反应量表(SRS)、儿童期孤独症评定量表(CARS)评估ASD儿童核心症状,采用线性回归分析严重挑食对ASD儿童体格生长和核心症状的影响。结果 ASD儿童的严重挑食率为56.5%(763/1 349),TD儿童的严重挑食率为29.7%(348/1 170)。调整混杂因素后,发现患有ASD和两组儿童的年龄是发生严重挑食的影响因素(OR=3.075、1.183、1.156,P<0.05)。严重挑食显著影响ASD儿童体重、体重指数(BMI)、ABC量表总分及其余分项和SRS量表总分及其余分项(β=-0.220、-0.319、6.305、1.139、2.111、1.043、1.427、0.946、5.908、0.597、1.029、1.517、1.328、1.503,P<0.05)。结论 ASD儿童严重挑食发生率高,持续比例高,同时严重挑食显著影响体重和BMI,并且与ASD核心症状存在关联。为此,临床工作中要关注ASD儿童挑食行为的评估,从而对患儿进行早期识别和精准干预。

关键词: 孤独症谱系障碍, 严重挑食, 核心症状, 儿童

Abstract: Objective To investigate the relationship between severely picky eating and the core symptoms among children with autism spectrum disorder(ASD),so as to provide reference for early identification and targeted intervention. Methods From May 2018 to December 2019,1 349 children aged 2 to 7 years were enrolled in this study from 13 hospitals in 13 cities across the country,meanwhile 1 170 typically developed children were recruited. A self-made questionnaire was used to investigate the picky eating status of ASD children. Autism Behavior Scale(ABC),Social Response Scale(SRS) and Childhood Autism Rating Scale(CARS) were used to assess the core symptoms of ASD children. Linear regression was used to analyze the impact of severely picky eating on physical growth and core symptoms of ASD. Results The rate of severely picky eating in ASD children was 56.5%(763/1 349),which was 29.7%(348/1 170) in TD children. It was found that ASD and the age of children in two groups were risk factors for occurrence of severe picky eating after adjusting for confounding factors(OR=3.075,1.183,1.156,P<0.05). Severely picky eating significantly affected ASD children's weight,body mass index(BMI),scores of ABC scale and subscales,scores of SRAS scale and subscales(β=-0.220,-0.319,6.305,1.139,2.111,1.043,1.427,0.946,5.908,0.597,1.029,1.517,1.328,1.503,P<0.05). Conclusions There is a high incidence and persistence of severely picky eaters in autistic children. Severely picky eating has significant impact on children's weight growth and BMI,and is associated with core symptoms of ASD. Therefore,clinical medical staff should pay more attention to the assessment of picky eating behaviors in ASD children,so as to carry out early identification and precise intervention of children.

Key words: autism spectrum disorder, severely picky eating, core symptoms, children

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