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目的:探讨天津市婴幼儿孤独症的患病率及相关危险因素,为今后孤独症病因研究提供线索。方法:应用巢式病例对照研究方法,按分层整群抽样的原则随机抽取天津市7 904名1.5～3岁的儿童进行孤独症筛查,对412名筛查阳性儿童进行追踪,年龄满3岁时进行孤独症确诊;每个病例按相同性别月龄匹配4例对照,因素调查表分为四部分,每部分分别进行单因素及多因素条件Logistic回归。结果:22例确诊为孤独症,天津市婴幼儿孤独症患病率及其95%的可信区间为27.83/万(16.22/万～39.44/万),男性孤独症患病率是女性的4倍(P<0.05)。单因素分析时发现孤独症的危险因素总共有8个,各部分多因素分析显示主要危险因素为:父亲有害职业史、母亲人工流产史、被动吸烟、妊娠浮肿、妊娠呕吐、新生儿黄疸。结论:孤独症不应再被认为是极罕见病,环境因素与孤独症发病有一定关系。
Objective: To investigate the prevalence and related risk factors of infantile autism in Tianjin, and to provide clues for the study of the cause of autism in future. Methods: A nested case-control study was conducted. According to the principle of stratified cluster sampling, 7 904 children aged 1.5 to 3 years in Tianjin were randomly selected to carry out autism screening. 412 children with screening positive were followed up and aged 3 At age of autism diagnosis; each case by the same sex age matched 4 cases of control, factor questionnaire is divided into four parts, each part of the single factor and multivariate conditional logistic regression. Results: Of the 22 cases diagnosed as autism, the prevalence of autism in infants and toddlers in Tianjin was 27.83 / million (16.22 / million to 39.44 / million), the prevalence of autism in males was 4 Times (P <0.05). Univariate analysis found that a total of 8 risk factors for autism, multivariate analysis of various factors showed that the main risk factors are: father’s harmful occupational history, mother’s abortion history, passive smoking, pregnancy edema, pregnancy vomiting, neonatal jaundice. Conclusion: Autism should no longer be considered as a very rare disease, environmental factors and the incidence of autism has a certain relationship.