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目的了解××市孤独谱系障碍(autism spectrum disorder,ASD)患病情况,探讨在儿童保健系统中实施ASD早期筛查有效模式。方法采用分层整群抽样法,抽取1.5~3.0岁幼儿2 090人。应用定期反复三级筛查逐级转诊模式,孤独症筛查量表(CHAT-23)、克氏孤独症行为量表(Clancy Autism Behavior Rating Scale,CABRS)为一级筛查工具,可疑者由儿童精神科医生依DSM-Ⅴ标准进行确诊;半年后复查。结果首次一级筛查,ASD阳性448人,筛查阳性率21.44%;半年复筛现漏诊4人,假阳性2人;终确诊ASD 26人,患病率1.24%。结论据DSM-Ⅴ诊断标准,应用CHAT-23和CABRS为一级筛查工具,××市ASD患病率接近美国最近报道,普遍高于国内,提示在儿童保健系统中两量表结合,有助于早期识别ASD;采用定期反复三级筛查逐级转诊模式,利于ASD早期发现和减少漏诊,适合推广。
Objective To investigate the prevalence of autism spectrum disorder (ASD) in ×× × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × × | Methods A stratified cluster sampling method was used to collect 2 090 children aged 1.5-3.0 years. The level-3 repeat screening model was used. The autism screening scale (CHAT-23) and Clancy Autism Behavior Rating Scale (CABRS) Diagnosed by children’s psychiatrist according to DSM-V standard; reviewed after six months. Results For the first time screening, 448 ASDs were positive, and the positive rate of screening was 21.44%. Four patients missed the screening in half a year and 2 were false positives. The final diagnosis of ASD was 26 with a prevalence of 1.24%. Conclusions According to the DSM-V diagnostic criteria, CHAT-23 and CABRS are first-class screening tools. The prevalence of ASD in ×× city is close to that of the United States recently and generally higher than that in China, suggesting that the two scales in children’s health care system are combined with Help early identification of ASD; the use of repeated three-stage screening repeated classification mode, which will help early detection and reduce ASD missed diagnosis, suitable for promotion.