浙江中医药大学附属第三医院儿科;
目的 探讨孤独症谱系障碍(ASD)儿童核心症状与血清微量元素的关联。方法 以2019—2022年经浙江中医药大学附属第三医院收治的ASD患儿105例为观察组，同期控制年龄、性别按1∶1比例匹配105例健康体检儿童为对照组，观察组采用孤独症行为量表(ABC)、社交反应量表(SRS)和孤独症评分量表(CARS)评估核心症状，两组均采用电感耦合等离子体质谱法(ICP-MS)测定血清微量元素水平，比较两组血清微量元素水平；按CARS量表评分划分为轻中度ASD组、重度组，分析血清微量元素水平差异，采用偏相关分析血清微量元素水平与ABC、SRS量表评分的关联。结果 除铁浓度外，观察组镁、铜、锌浓度均低于对照组，差异有统计学意义[(18.34±0.76)mg/L vs.(19.25±0.84)mg/L、(1.07±0.09)mg/L vs.(1.17±0.10)mg/L、(0.72±0.04)mg/L vs.(0.78±0.05)mg/L](P<0.05)。参考CARS量表评分标准，轻至中度ASD患儿72例，重度ASD患儿33例，除铁浓度外，重度组镁、铜、锌浓度均低于轻至中度组，差异有统计学意义[(18.01±0.73)mg/L vs.(18.84±0.80)mg/L、(1.03±0.07)mg/L vs.(1.09±0.10)mg/L、(0.68±0.03)mg/L vs.(0.74±0.05)mg/L](P<0.05)。血清镁与ABC量表中躯体运动能力、语言能力及交往能力呈负相关(r分别为-0.334、-0.252、-0.307)(P<0.05),血清铁与ABC量表各维度均无明显相关性(P>0.05);血清铜与ABC量表中躯体运动能力及交往能力呈负相关(r分别为-0.291、-0.261,P<0.05);血清锌与ABC量表中躯体运动能力、语言能力及交往能力呈负相关(r分别为-0.386、-0.302、-0.391,P<0.05);血清镁与SRS量表中社交沟通、社交认知及ASD行为方式呈负相关(r分别为-0.303、-0.284、-0.317,P<0.05);血清铁与SRS量表各维度均无明显相关性(P>0.05);血清铜与SRS量表中社交沟通及ASD行为方式呈负相关(r分别为-0.250、-0.289,P<0.05);血清锌与SRS量表中社交沟通、社交认知及ASD行为方式呈负相关(r分别为-0.342、-0.292、-0.329,P<0.05)。结论 ASD患儿核心症状与血清微量元素存在一定关联，通过监测血清微量元素水平可帮助识别ASD核心症状变化，便于制定个体化对策进行有效干预。
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基本信息:
DOI：10.19829/j.zgfybj.issn.1001-4411.2024.21.004
中图分类号:R749.94
引用信息:
[1]马聪,吕玲玲,张慧婷.孤独症谱系障碍儿童核心症状与血清微量元素的关联[J].中国妇幼保健,2024,39(21):4148-4151.DOI:10.19829/j.zgfybj.issn.1001-4411.2024.21.004.
基金信息: