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目的通过对比分析孤独症谱系障碍(ASD)儿童和正常儿童的健康影响因素差异,进一步探索儿童ASD的发病因素,为ASD防治提供参考依据。方法采用1∶1病例对照研究回顾性调查2014年5月至2015年5月辽宁省锦州市妇婴医院诊治的196例ASD儿童和体检正常的非ASD儿童,填写自拟健康影响因素调查问卷,对比分析两组儿童发育指标及影响因素差异。结果两组间平均身高、体重差异无统计学意义(P>0.05),ASD组儿童头围大于对照组,差异有统计学意义(t=2.41,P=0.02)。条件Logistic回归分析显示儿童一眼识别理解能力(β=-3.077)、头围(β=0.341)差异均有统计学意义(P均<0.05)。母亲生育年龄>35岁、家庭关系、有家族神经障碍类疾病史、父亲从事劳动类型等变量回归系数检验均有统计学意义(P均<0.05),与疾病发生有关联;孕期情绪急躁易怒(β=1.966,OR=7.144)、精神刺激(β=2.067,OR=7.902)和妊娠呕吐(β=2.576,OR=13.138)等因素与疾病发生呈正向相关(P均<0.05);而补充营养品(β=-2.435,OR=0.088)、胎动正常(β=-2.008,OR=0.134)与ASD呈负向关联(P均<0.05)。结论母亲年龄超过35岁、父亲从事体力劳动、家庭关系紧张、有家族神经障碍疾病史、精神刺激、孕期情绪暴躁、妊娠呕吐等因素可能是ASD发病的危险因素;而母亲在35岁前生育、孕期及时补充营养品、保持心情愉悦,同时在儿童生长发育过程中注意与其语言交流、监测头围正常,保持家庭和谐,增加对儿童的陪伴在一定程度上能降低ASD的发生。
Objective To compare and analyze the difference of health factors between children with autism spectrum disorder (ASD) and normal children, to further explore the risk factors of children with ASD and to provide a reference for the prevention and treatment of ASD. Methods The 1: 1 case-control study retrospectively reviewed 196 ASD children and normal non-ASD children diagnosed and treated in Maternal and Child Hospital of Jinzhou City, Liaoning Province from May 2014 to May 2015. The questionnaires of self-prepared health factors, Comparative analysis of two groups of children’s developmental indicators and the influencing factors. Results There was no significant difference in average height and weight between the two groups (P> 0.05). The head circumference of ASD group was larger than that of the control group (t = 2.41, P = 0.02). Conditional logistic regression analysis showed that children had a clear understanding of cognitive ability (β = -3.077) and head circumference (β = 0.341) (all P <0.05). The multivariate regression coefficients of maternal age> 35, familial relationship, history of family history of neurological disorders, and type of work of father were statistically significant (all P <0.05), and were associated with the disease. Emotional irritability during pregnancy (β = 2.066, OR = 7.902) and vomiting in pregnancy (β = 2.576, OR = 13.138) were positively correlated with the incidence of the disease (P < Nutritional products (β = -2.435, OR = 0.088), normal fetal movement (β = -2.008, OR = 0.134) were negatively correlated with ASD (all P <0.05). Conclusion The mothers aged 35 or older, father engaged in manual labor, nervous family relations, family history of neurological disorders, mental stimulation, emotional irritability during pregnancy, vomiting and other factors may be risk factors for the onset of ASD; while the mother before the age of 35 fertility, Pregnancy supplements in a timely manner, to maintain a good mood, while children in the process of growth and development and pay attention to their language exchange, monitoring head circumference normal, to maintain family harmony, increased children’s companionship to a certain extent, can reduce the occurrence of ASD.