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【目的】了解北京市0~6岁智力低下(mental retardation,MR)儿童病因构成特点及相关致病因素,为政府相关部门制定政策提供科学依据。【方法】采用概率比例、二阶段分层整群抽样方法进行横断面调查及病例对照研究,使用丹佛发育筛查测验及Gesell发育诊断量表分别进行智力筛查和诊断。【结果】①本次共调查0~6岁儿童28 738人,智力残疾现患率为9.31‰。②北京市0~6岁智力低下儿童主要致病原因以围产因素、社会心理因素为主;按病因的作用时间分析,出生前因素占首位;农村的社会文化心理因素所致MR比例远远高于城市。③性别为男性、母亲的文化水平低、母亲生育年龄偏高、近亲结婚、居住在城市是儿童智力低下发生的重要影响因素;母孕期受一定的精神刺激、家族中有五类残疾、出生窒息、出生低体重、在婴幼儿期患过与脑发育有关的疾病是智力低下发生的生物相关致病因素。【结论】儿童智力低下的预防应以围生期因素、社会文化因素为主,防治重点应在农村。
【Objective】 To understand the etiopathogenisis and related risk factors of children with mental retardation (MR) in 0 ~ 6 years old in Beijing and to provide scientific basis for the government to formulate policies. 【Methods】 Cross-sectional investigation and case-control study were conducted by probability proportion and two-stage stratified cluster sampling method. The intelligence screening and diagnosis were performed using Denver Developmental Screening Test and Gesell Developmental Diagnostic Scale respectively. 【Results】 ① A total of 28 738 children aged 0-6 years were investigated. The prevalence of mental retardation was 9.31 ‰. ② The main causes of the mental retardation in 0- to 6-year-old children with mental retardation in Beijing are mainly perinatological factors and social psychological factors. According to the analysis of the time of cause and effect, the prenatal factors are the most important. The social psychological factors in rural areas are far from MR Above the city. (3) Sex is male, mother’s educational level is low, mother’s childbearing age is higher, her cousins get married, and living in the city is an important factor affecting children’s mental retardation. During the first trimester, she has five kinds of disabilities and birth asphyxia , Low birth weight, and early childhood illnesses associated with brain development are biologically relevant risk factors for mental retardation. [Conclusion] Prevention of mental retardation in children should be based on perinatal factors, social and cultural factors, prevention and treatment should focus on rural areas.