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目的了解孤独症谱系障碍(ASD)的核心症状对患儿健康相关生命质量(HRQoL)的影响。方法以2014年4-10月在重医附属儿童医院儿保科参加结构化训练的患儿为研究对象,采用自设孤独症核心症状问卷及PedsQLTM4.0生命质量家长报告,分析ASD核心症状与PedsQoL总体及各维度的关系。结果 1)核心症状中重复刻板行为及狭隘兴趣与PedsQoL总分、情感及社交功能呈负相关(r=-0.503,-0.600,-0.474,P均<0.01),与生理及学校功能无显著相关;社交沟通及社会互动障碍与ASD患儿PedsQoL总分及各功能区均无显著相关。2)轻度重复刻板行为及狭隘兴趣的ASD患儿在PedsQL总得分及各功能区得分均高于重度的患儿,其中在情感及社交功能方面的差异有统计学意义(P<0.05),总体生命质量、生理功能、学校功能差异无统计学意义。结论 ASD患儿HRQoL与重复刻板行为及狭隘兴趣有关,重复刻板行为及狭隘兴趣症状越重,ASD患儿的HRQoL越差。改善孤独症患儿重复刻板行为及狭隘兴趣,将有助于提高孤独症患儿HRQoL。
Objective To understand the impact of core symptoms of autism spectrum disorder (ASD) on health-related quality of life (HRQoL) in children. Methods From April to October 2014, children with structured training in pediatrics department of Children’s Hospital of Chongming Medical College were enrolled in this study. The core autism questionnaire and the PedsQLTM 4.0 quality of life parents report were used to analyze the association between ASD core symptoms and PedsQoL Overall and the relationship between the various dimensions. Results 1) Repeated stereotyped behaviors and narrow interest in core symptoms were negatively correlated with PedsQoL score, emotion and social function (r = -0.503, -0.600, -0.474, P <0.01), but not with physical and school function There was no significant correlation between social communication and social interaction disorder and PedsQoL score and functional areas in children with ASD. 2) Children with ASD who had mild repetitive stereotypes and narrow interests had higher scores on PedsQL and scores in all functional areas than those with severe ASD. The differences in emotion and social function were statistically significant (P <0.05) The overall quality of life, physiological function, school function difference was not statistically significant. Conclusion The HRQoL in children with ASD is related to repeated stereotypes and narrow interests. The more repetitive stereotypes and narrow interest symptoms, the worse HRQoL in children with ASD. Improving autistic children with repeated stereotypes and narrow interests, will help improve children with autism HRQoL.