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目的通过对1岁以内孤独症警示指标阳性患儿进行随访3年,了解孤独症警示指标阳性患儿的结局及预后。方法在高危儿门诊采用2010年卫生部颁布《儿童孤独症诊疗康复指南》中婴儿期孤独症警示指标对阳性患儿进行跟踪检查、家庭干预指导、定期评估及3年随访;并将3岁时确诊孤独症的儿童(实验组)与随机抽取的儿童孤独症门诊就诊的相同年龄段的儿童(对照组)用儿童孤独症评定量表(CARS)及Gesell发育量表进行评估,将各组结果进行对比分析。结果警示指标阳性患儿35人中3年后确诊孤独症谱系障碍30人,5例其他,包括智力发育迟缓2例、先天性色素失禁症1例、结节性硬化1例,先天性盲童1例,所有患儿均进行早期干预;两组ASD儿童CARS评分:实验组低于对照组,证实对照组严重程度高于实验组,差异有统计学意义(P<0.001);Gesell发育量表检测两组5个能区数值均低于正常,但对照组的儿童各能区平均水平均低于实验组,且各能区间差异有高度统计学意义(P<0.001)。结论利用婴儿孤独症早期阳性警示指标进行儿童孤独症的早期筛查具有可行性,有利于减轻孤独症的严重程度和提高孤独症儿童的各项能力。
Objective To investigate the outcome and prognosis of children with positive autism warning sign after 3 years of follow-up of children with autism warning sign within 1 year of age. Methods In high-risk infants clinics, follow-up examination, family intervention guidance, regular assessment and 3-year follow-up were conducted in infants with autism warning indicators in infants during the autism in 2010. Children with autism (experimental group) and randomly selected children with autism at the same age group (control group) were evaluated using the Children’s Autism Rating Scale (CARS) and Gesell Development Scale, and the results of each group For comparative analysis. Results Among the 35 children with positive warning sign, 30 were diagnosed with autism spectrum disorder 3 years later and 5 others were included, including 2 cases of mental retardation, 1 case of congenital pigmentosis, 1 case of tuberous sclerosis and 1 case of congenital blind child 1 case, and all the children had early intervention. The CARS score of two ASD children in the two groups was lower than that of the control group, showing that the severity of the control group was higher than that of the experimental group (P <0.001) The mean energy levels of five energy regions in both groups were lower than those in the normal group. However, the average energy levels in each group in the control group were lower than those in the experimental group (P <0.001). Conclusion It is feasible to use early positive warning indicators of infant autism to carry out early screening of children with autism. It is helpful to reduce the severity of autism and improve the abilities of children with autism.