孤独症患儿发育倒退特征的研究

Characteristics of developmental regression in autistic children

摘要:

目的：大约30%左右孤独症的患儿在2岁左右出现发育倒退。“倒退型”患儿的病程发展、临床表现尚不十分清楚，因此该研究对一组有发育倒退特征的孤独症患儿进行了研究。方法：符合DSM-IV孤独症诊断标准的孤独症患儿152例, 年龄2.5～6.5岁,根据有无语言发育倒退进行分组。调查患儿的围产期情况、发育史及发育倒退的特征，并对两组患儿的症状进行比较。结果：33例(21.7％)患儿在生后16~21个月时出现语言及社交功能的倒退。CARS量表(Childhood Autism Rating Scale)的评分比较显示倒退组明显高于非倒退组（P<0.05）；倒退组中重症患儿所占比例（66.7%）明显高于非倒退组（45.4%）（P<0.05）。结论：发育倒退在孤独症中占有一定的比例，对于孤独症的诊断具有意义。倒退型患儿的症状程度比非倒退型患儿更为严重，提示倒退型可能为孤独症的一类特殊表型。［中国当代儿科杂志，2010，12（10）：781-783］

Abstract:

OBJECTIVE: About 30% of autistic cases experience developmental regression around 2 years of age. The clinical course and manifestations of autistic children with regression remain unclear. This study investigated the clinical features of a group of autistic children with regression. METHODS: One hundred and fifty-two children at ages of 2.5-6.5 years confirmed with autism based on DSM-IV diagnostic criteria were enrolled. They were grouped according to language development: normal or regression. The perinatal history, developmental history and characteristics of regression were investigated. The symptoms were compared between the two groups. RESULTS: Regressions were observed in 33 children (21.7%) at age of between 16 and 21 months, with loss both in communicative skills and social engagement. The regressive group was scored significantly higher on the Childhood Autism Rating Scale (CARS) (P<0.05) and had a relatively higher proportion of severely ill children (66.7% vs 45.4%; P<0.05）compared with the non-regressive group. CONCLUSIONS: Regression as a characteristic symptom occurs in some autistic children and is of value for diagnosis of autism. The autistic children with regression display more severe social and language impairments than those without regression. Regressive autism may be a special subtype.［Chin J Contemp Pediatr, 2010, 12 (10):781-783］