Shi H F, Zhang J X, Zhang R, Wang X L
Department of Maternal and Child Health, Peking University School of Public Health, Beijing 100191, China.
Department of Maternal and Child Health, Peking University School of Public Health, Beijing 100191, China; Autism Research Center, Peking University Health Science Center, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2017 Oct 18;49(5):798-806.
To estimate the prevalence and trend of autism spectrum disorders (ASD) in children aged 0-6 years in China.
Systematic literature searches were conducted in PubMed, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang and Weipu Database (VIP ), and the literatures published before February 25, 2017 were selected according to the same criteria. Prevalence Data of three periods were abstracted, then pooled using random effect model. Subgroup analysis was done across data resource, age group, screening criteria, diagnostic criteria, and literature quality.
In the study, 9 ASD studies and 20 autism (also known as autistic disorder, AD) studies were eligible for review. The pooled prevalence of AD in children aged 0-6 years in 2006-2010 and 2011-2015 was 1.74 ‰ (95%CI: 1.12‰-2.69‰) and 1.80‰ (95%CI: 1.33‰-2.43‰), and there was no significant difference between the two groups (P=0.898), but they were higher than 0.94‰ (95%CI: 0.67‰-1.33‰) in 1996-2005 (P=0.031; P=0.005) significantly. The pooled prevalence of ASD in children aged 0-6 years was 3.52 ‰ (95% CI: 1.48‰-8.34‰) and 3.48‰ (95%CI: 1.77‰-6.84‰) in 2006-2010 and 2011-2015, respectively, and the difference between the two periods was not significant (P=0.983). There was no significant difference between the pooled prevalence in the three periods among the boys, and girls' too. The pooled prevalence of ASD in children aged 0-6 years was 3.51‰ (95%CI: 2.15‰-5.74‰) and AD was 1.77‰ (95%CI: 1.40‰-2.24‰) in 2006-2015, with prevalence ratios of boys to girls 2.59:1 and 3.63:1, respectively. The pooled prevalence of AD was lower in 0-6 years children than in other age groups and higher in high-quality studies than in low-quality studies, which was the same as ASD. Data resource, screening and diagnostic criteria were not significantly related with the pooled prevalence of AD and ASD.
The prevalence of ASD and AD in children aged 0-6 years in China from 2006 to 2015 was stable, and there was not enough evidence to prove that it was higher than before 2005. National survey and monitoring of early childhood autism should to be conducted.
评估中国0至6岁儿童自闭症谱系障碍（ASD）的患病率及变化趋势。
在PubMed、Web of Science、Scopus、中国知网（CNKI）、中国生物医学文献数据库（CBM）、万方和维普数据库（VIP）中进行系统的文献检索，并根据相同标准选取2017年2月25日前发表的文献。提取三个时期的患病率数据，然后采用随机效应模型进行汇总。对数据来源、年龄组、筛查标准、诊断标准和文献质量进行亚组分析。
本研究中，9项ASD研究和20项自闭症（又称孤独症，AD）研究符合纳入标准。2006 - 2010年和2011 - 2015年0至6岁儿童AD的合并患病率分别为1.74‰（95%CI：1.12‰ - 2.69‰）和1.80‰（95%CI：1.33‰ - 2.43‰），两组间差异无统计学意义（P = 0.898），但均显著高于1996 - 2005年的0.94‰（95%CI：0.67‰ - 1.33‰）（P = 0.031；P = 0.005）。2006 - 2010年和2011 - 2015年0至6岁儿童ASD的合并患病率分别为3.52‰（95%CI：1.48‰ - 8.34‰）和3.48‰（95%CI：1.77‰ - 6.84‰），两个时期差异无统计学意义（P = 0.983）。三个时期男孩和女孩的合并患病率差异均无统计学意义。2006 - 2015年0至6岁儿童ASD的合并患病率为3.51‰（95%CI：2.15‰ - 5.74‰），AD为1.77‰（95%CI：1.40‰ - 2.24‰），男孩与女孩的患病率之比分别为2.59∶1和3.63∶1。0至6岁儿童AD的合并患病率低于其他年龄组，高质量研究中的患病率高于低质量研究，ASD情况相同。数据来源、筛查和诊断标准与AD和ASD的合并患病率无显著相关性。
2006至2015年中国0至6岁儿童ASD和AD的患病率稳定，且尚无足够证据证明高于2005年以前。应开展全国性的幼儿自闭症调查和监测。
