University of New South Wales, Randwick, Sydney, NSW, Australia.
Dev Med Child Neurol. 2012 Apr;54(4):306-12. doi: 10.1111/j.1469-8749.2012.04223.x. Epub 2012 Feb 21.
It has been reported that rates of epilepsy and mortality are higher among the population with autism spectrum disorder (ASD) than in the general population. The aim of this systematic review is to provide comprehensive evidence for clinicians, carers, and people with ASD regarding these outcomes.
Studies were eligible for inclusion if the main focus of the study involved observation over a period of 12 months or more of an initially defined population (with appropriate diagnostic label). Studies were also required to have at least 30 participants in order to differentiate case series from cohort studies. The Cochrane Database of Systematic Reviews, the Database of Reviews of Effectiveness, MEDLINE, PsycINFO, EMBASE, and CINAHL were searched. The date of the last search was September 2010. The risk of bias of included studies was assessed and a meta-analysis was undertaken.
Twenty-one studies were identified, 16 measuring the percentage of participants with epilepsy and five measuring mortality using a standardized mortality ratio. The pooled estimate for the percentage of participants with epilepsy was 1.8% (95% CI 0.4-9.4%) in studies in which the majority did not have an intellectual disability and the mean age was <12 years at follow-up, and 23.7% (95% CI 17.5-30.5%) in studies in which the majority did have an intellectual disability and the mean age at follow-up was more than 12 years. The pooled estimate for the standardized mortality ratio was 2.8 (95% CI 1.8-4.2).
The prevalence of epilepsy is higher among the population with ASD than in the general population. People with ASD have a higher risk of mortality than the general population. This has important health promotion implications.
据报道，自闭症谱系障碍（ASD）患者的癫痫发病率和死亡率高于普通人群。本系统评价的目的是为临床医生、护理人员和 ASD 患者提供这些结果的综合证据。
如果研究的主要重点是在最初定义的人群（具有适当的诊断标签）中观察 12 个月或更长时间，则研究符合纳入标准；为了将病例系列与队列研究区分开来，研究还需要至少有 30 名参与者。对 Cochrane 系统评价数据库、疗效评价数据库、MEDLINE、PsycINFO、EMBASE 和 CINAHL 进行了检索。最后一次检索日期为 2010 年 9 月。对纳入研究的偏倚风险进行了评估，并进行了荟萃分析。
确定了 21 项研究，其中 16 项研究测量了癫痫患者的百分比，5 项研究使用标准化死亡率比测量了死亡率。在大多数患者没有智力障碍且随访时平均年龄<12 岁的研究中，癫痫患者的百分比汇总估计值为 1.8%（95%CI 0.4-9.4%），在大多数患者有智力障碍且随访时平均年龄超过 12 岁的研究中，癫痫患者的百分比汇总估计值为 23.7%（95%CI 17.5-30.5%）。标准化死亡率比的汇总估计值为 2.8（95%CI 1.8-4.2）。
ASD 患者的癫痫发病率高于普通人群。ASD 患者的死亡率高于普通人群。这具有重要的健康促进意义。
