唐山市2~5岁孤独症谱系障碍儿童体格发育及健康状况分析

崔立华; 杜文冉; 杨笑; 刘晨; 赵素君; 马奕宁; 董静怡; 庞淑兰; 冯福民

doi:10.16462/j.cnki.zhjbkz.2022.09.019

唐山市2~5岁孤独症谱系障碍儿童体格发育及健康状况分析

doi: 10.16462/j.cnki.zhjbkz.2022.09.019

1.
063210 唐山，华北理工大学公共卫生学院预防医学系
2.
063000 唐山，唐山市妇幼保健院儿童保健科
3.
063210 唐山，唐山市曹妃甸区妇幼保健院儿童保健科

基金项目:

河北省卫健委医学科学研究重点课题项目 20180734

河北省卫健委医学科学研究重点课题项目 20181318

详细信息

通讯作者:
冯福民，E-mail: fm_feng@sina.com

中图分类号: R179;R749.94
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- 被引次数: 0
出版历程
- 收稿日期: 2021-10-29
- 修回日期: 2022-04-08
- 网络出版日期: 2022-09-17
- 刊出日期: 2022-09-10

Physical development and health status of children with autism spectrum disorder aged 2-5 years in Tangshan

1.
Department of Preventive Medicine, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
2.
Department of Child Health Care, Tangshan Maternal and Child Health Care Hospital, Tangshan 063000, China
3.
Department of Child Health Care, Maternal and Child Health Care Hospital of Caofeidian District, Tangshan 063210, China

Funds:

Major Project of Medical Science of Health Commission of Hebei Province 20180734

Major Project of Medical Science of Health Commission of Hebei Province 20181318

More Information

Corresponding author: FENG Fu-min, E-mail: wuweiwei2008@sina.com

摘要

摘要: 目的了解唐山市2~5岁孤独症谱系障碍(autism spectrum disorders, ASD)儿童体格发育、营养及健康状况, 为制定干预措施提供依据。方法选取2019年3月-2021年6月在唐山市妇幼保健院就诊和特殊教育机构训练的208名2~5岁ASD儿童进行问卷调查和体格测量。依据WHO儿童生长发育标准, 分析年龄别身高(height for age Z score, HAZ)、年龄别体重(weight for age Z score, WAZ)和年龄别体质指数(body mass index for age Z score, BAZ)评价儿童生长状况。结果 ASD儿童的HAZ、WAZ和BAZ分布曲线左移, 向-2和+2外延伸。生长迟缓、消瘦、低体重、超重和肥胖率分别为4.3%、6.3%、1.4%、4.8%和4.3%。不同喂养方式(X²=7.836, P=0.020)、ASD严重程度(X²=13.011, P=0.001)及有无胃肠道症状(X²=4.513, P=0.034)组间消瘦率不同, 其中混合喂养组、重度ASD组、有胃肠道症状组的消瘦率最高。月患病率为58.2%, 居前三位的是急性上呼吸道感染、流行性感冒和胃肠炎, 分别占比为46.2%、9.1%和4.8%。结论唐山市ASD儿童的体格发育存在生长偏离, 常见病患病率较高, 应加强生长监测、营养干预及疾病预防。
- 孤独症谱系障碍 /
- 儿童 /
- 体格发育 /
- 营养 /
- 患病率
Abstract: Objective To investigate the physical development, nutrition and health status of children with autism spectrum disorder (ASD) aged 2-5 years in Tangshan, so as to provide evidence for formulating intervention measures. Methods A total of 208 children with ASD aged 2-5 years from Tangshan Maternal and Child Health Hospital and special education institutions from March 2019 to June 2021 were recruited for questionnaire survey and physical measurement.Indexes of height for age Z score (HAZ), weight for age Z score (WAZ) and body mass index for age Z score (BAZ) were used to evaluate growth status according to WHO child growth standard. Results The distribution curves of HAZ, WAZ and BAZ in ASD children shifted to the left side extending beyond-2 and+2.The rates of stunting, wasting, underweight, overweight, obesity in ASD children were 4.3%, 6.3%, 1.4%, 4.8% and 4.3%, respectively.The wasting rate among different groups with feeding methods (X²=7.836, P=0.020), ASD severity (X²=13.011, P=0.001) and groups with whether gastrointestinal symptoms (X²=4.513, P=0.034) were different, which of the mixed feeding group and severe ASD groups and group with gastrointestinal symptoms were the highest.The monthly prevalence rate of children with ASD was 58.2% and the top three diseases were acute upper respiratory tract infections, influenza and gastroenteritis, accounting for 46.2%, 9.1% and 4.8% respectively. Conclusions The children with ASD show deviation of physical development and the high prevalence rate of common diseases in Tangshan.It is necessary to strengthen growth monitoring, nutrition intervention and disease prevention to them.
- Autism spectrum disorder /
- Children /
- Physical development /
- Nutrition /
- Prevalence rate

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图 1 ASD儿童HAZ、WAZ和BAZ分布情况

注：虚线为普通人群Z值正态分布曲线，为参考线；实线为ASD儿童各指标的分布曲线；条形柱为ASD儿童各指标分布频率。

Figure 1. Distribution of HAZ, WAZ and BAZ in children with ASD

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表 1 唐山市2~5岁ASD儿童的身高、体重与“中国九市儿童体格发育”结果比较

变量	人数	身高/身长				体重
变量	人数	实测值(cm, x±s)	参考值(cm)	t值	P值	实测值(kg, x±s)	参考值(kg)	t值	P值
男
2~<2.5	40	89.42±3.76	90.6	-1.988	0.054	11.92±1.36	13.0	-4.841	0.001
2.5~<3	44	95.24±3.24	95.6	-0.740	0.463	13.85±1.38	14.3	-2.058	0.046
3~<3.5	38	98.21±5.02	99.4	-1.457	0.153	15.48±2.17	15.5	-0.052	0.959
3.5~<4	18	102.03±3.20	103.2	-1.546	0.141	16.41±1.67	16.6	-0.489	0.631
4~<4.5	7	103.29±4.11	106.7	-2.197	0.070	16.27±2.31	17.8	-1.749	0.131
4.5~<5	14	107.11±4.42	110.1	-2.533	0.025	18.72±3.89	19.0	-0.274	0.788
5~<5.5	6	110.00±4.38	114.1	-2.292	0.068	19.43±2.77	20.4	-0.863	0.427
5.5~6	6	115.75±0.82	117.1	-4.025	0.010	19.48±0.53	21.7	-10.342	0.001
女
2~<2.5	15	85.97±4.06	89.3	-3.183	0.007	12.47±1.70	12.4	0.242	0.812
2.5~<3	6	89.00±1.10	94.2	-11.628	0.001	12.75±1.13	13.6	-1.779	0.135
3~<3.5	0
3.5~<4	7	97.86±2.67	102.0	-4.101	0.006	14.71±1.60	16.0	-2.121	0.078
4~<4.5	4	103.63±1.11	105.4	-3.202	0.049	15.20±0.42	16.9	-8.014	0.004
4.5~<5	0
5~5.5	3	106.67±1.53	112.8	-6.955	0.020	16.63±0.48	19.5	-10.365	0.009

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表 2 不同组间ASD儿童HAZ、WAZ和BAZ比较

Table 2. Comparison of HAZ, WAZ and BAZ of ASD children in different groups

变量	例数	HAZ(x±s)	WAZ(x±s)	BAZ [M (P₂₅, P₇₅)]
性别
男	173	0.17±1.14	0.06±1.04	-0.20 (-0.75, 0.55)
女	35	-0.27±0.94	0.00±1.10	0.39 (-0.65, 0.54)
Z/t值		2.142	0.290	-1.021
P值		0.033	0.772	0.307
年龄(岁)
2.0~<3.0	104	0.23±1.09	-0.07±0.99	-0.42 (-1.07, 0.39)
3.0~<4.0	64	0.09±1.25	0.29±1.05	0.09 (-0.43, 0.87) ^a
4.0~<5.0	25	-0.39±0.97	0.02±1.34	0.03 (-0.70, 1.23)
5.0	15	-0.07±0.67	-0.09±0.74	-0.34 (-0.42, 0.20)
H/F值		2.201	1.607	11.801
P值		0.089	0.189	0.008
ASD严重程度
非典型	90	0.10±1.18	0.04±1.12	-0.15 (-0.69, 0.54)
轻中度	74	-0.04±1.08	0.19±0.99	0.03 (-0.47, 0.94)
重度	44	0.30±1.05	-0.16±0.98	-0.51 (-1.06, 0.19) ^b
H/F值		1.257	1.507	11.029
P值		0.287	0.224	0.004
胃肠道症状
有	65	0.00±1.24	-0.12±1.26	-0.51 (-1.07, 0.47)
无	143	0.13±1.06	0.13±0.93	-0.04 (-0.65, 0.61)
Z/t值		-0.752	-1.408	-2.088
P值		0.453	0.162	0.037
注:表示与2~<3岁组比较,P<0.05; 表示与轻中度组比较,P<0.05。

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参考文献(15)

[1]	Maenner MJ, Shaw KA, Baio J, et al. Prevalence of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network, 11 sites, United States, 2016[J]. MMWR Surveill Summ, 2020, 69(4): 1-12. DOI: 10.15585/mmwr.ss6904a1.
[2]	赵亚楠, 罗雅楠, 王翔宇, 等. 中国2~6岁孤独症儿童家庭直接经济负担研究[J]. 中华疾病控制杂志, 2021, 25(9): 1085-1090. DOI: 10.16462/j.cnki.zhjbkz.2021.09.016. Zhao YN, Luo YN, Wang XY, et al. Research on the direct financial burden on families with 2-6 years old children having autism spectrum disorder in China[J]. Chin J Dis Control Prev, 2021, 25(9): 1085-1090. DOI: 10.16462/j.cnki.zhjbkz.2021.09.016.
[3]	Mccoy SM, Morgan K. Obesity, physical activity, and sedentary behaviors in adolescents with autism spectrum disorder compared with typically developing peers[J]. Autism, 2020, 24(2): 387-399. DOI: 10.1177/1362361319861579.
[4]	Gok S, Ozturk SN, Karaca R, et al. Evaluation of sleep disturbances, gastrointestinal problems and eating behaviors in Turkish children with autistic disorder and PDD-NOS[J]. Advances in Autism, 2021, 7(2): 101-113. DOI: 10.1108/AIA-12-2019-0049.
[5]	Kamal NN, Ghozali AH, Ismail J. Prevalence of overweight and obesity among children and adolescents with autism spectrum disorder and associated risk factors[J]. Front Pediatr, 2019, 7: 38. DOI: 10.3389/fped.2019.00038.
[6]	杨睿博, 刘佳雪, 韩钰, 等. 天津市3~7岁孤独症谱系障碍儿童体格发育和营养状况研究[J]. 中国儿童保健杂志, 2021, 29(10): 1058-1062, 1081. DOI: 10.11852/zgetbjzz2021-0543. Yang RB, Liu JX, Han Y, et al. Study on physical development and nutritional status of children with autism spectrum disorders aged 3-7 years in Tianjin[J]. Chin J Child Health Care, 2021, 29(10): 1058-1062, 1081. DOI: 10.11852/zgetbjzz2021-0543.
[7]	李慧萍, 徐琼, 胡梅新, 等. 孤独症谱系障碍儿童体格生长状况的横断面调查[J]. 中国循证儿科杂志, 2020, 15(3): 220-223. DOI: 10.3969/j.issn.1673-5501.2020.03.012. Li HP, Xu Q, Hu MX, et al. Growth status of children with autism spectrum disorder: a cross-sectional study[J]. Chin J Evid Based Pediatr, 2020, 15(3): 220-223. DOI: 10.3969/j.issn.1673-5501.2020.03.012.
[8]	宗心南, 李辉. 2016年中国九城市七岁以下儿童单纯性肥胖流行病学调查[J]. 中华儿科杂志, 2018, 56(10): 745-752. DOI: 10.3760/cma.j.issn.0578-1310.2018.10.006. Zong XN, Li H. A national epidemiological survey on obesity of children under seven years of age in nine cities of China in 2016[J]. Chin J Pediatr, 2018, 56(10): 745-752. DOI: 10.3760/cma.j.issn.0578-1310.2018.10.006.
[9]	Liu X, Liu J, Xiong X, et al. Correlation between nutrition and symptoms: nutritional survey of children with autism spectrum disorder in Chongqing, China[J]. Nutrients, 2016, 8(5): 294. DOI: 10.3390/nu8050294.
[10]	张亚钦, 李辉, 武华红, 等. 中国九市七岁以下儿童生长迟缓状况调查研究[J]. 中华儿科杂志, 2020, 58(3): 194-200. DOI: 10.3760/cma.j.issn.0578-1310.2020.03.007. Zhang YQ, Li H, Wu HH, et al. Survey on the stunting of children under seven years of age in nine cities of China[J]. Chin J Pediatr, 2020, 58(3): 194-200. DOI: 10.3760/cma.j.issn.0578-1310.2020.03.007.
[11]	于冬梅, 房红芸, 许晓丽, 等. 中国2013年0~5岁学龄前儿童营养不良状况分析[J]. 中国公共卫生, 2019, 35(10): 1339-1344. DOI: 10.11847/zgggws1122481. Yu DM, Fang HY, Xu XL, et al. Prevalence of undernutrition among 0-5 years old children in China in 2013[J]. Chin J Public Health, 2019, 35(10): 1339-1344. DOI: 10.11847/zgggws1122481.
[12]	Yeung S, Chan R, Li L, et al. Eating behaviors and diet quality in Chinese preschoolers with and without autism spectrum disorder: a case-control study[J]. J Pediatr, 2021, 237: 258-266(e5). DOI: 10.1016/j.jpeds.2021.06.017.
[13]	Sena Z, Bayhan P. An investigation of the relationship between the eating behaviors of children with typical development and autism spectrum disorders and parent attitudes during mealtime[J]. Child Care Health Dev, 2021, 47(6): 877-885. DOI: 10.1111/cch.12899.
[14]	Levy SE, Pinto-Martin JA, Bradley CB, et al. Relationship of weight outcomes, co-occurring conditions, and severity of autism spectrum disorder in the study to explore early development[J]. J Pediatr, 2019, 205: 202-209. DOI: 10.1016/j.jpeds.2018.09.003.
[15]	刘思家, 张黎, 王远萍, 等. 2018-2019年上海市浦东新区儿童急性呼吸道感染患病及就诊行为[J]. 中华疾病控制杂志, 2020, 24(8): 886-891. DOI: 10.16462/j.cnki.zhjbkz.2020.08.005. Liu SJ, Zhang L, Wang YP, et al. Prevalence and healthcare-seeking practices of children with acute respiratory infections in Pudong, Shanghai during 2018-2019[J]. Chin J Dis Control Prev, 2020, 24(8): 886-891. DOI: 10.16462/j.cnki.zhjbkz.2020.08.005.