Fombonne E, Du Mazaubrun C, Cans C, Grandjean H
Institut National de la Santé et de la Recherche Médicale (INSERM), Paris.
J Am Acad Child Adolesc Psychiatry. 1997 Nov;36(11):1561-9. doi: 10.1016/S0890-8567(09)66566-7.
To estimate the prevalence of autism, to assess the strength of its association with specific medical disorders, and to test for a secular increase in its incidence.
An epidemiological survey was conducted among 325,347 French children born between 1976 and 1985 and living in three different French départements. Diagnosis, educational level, and associated medical conditions were abstracted from the records of children known to local educational authorities. Data were also pooled with those from another similar survey.
One hundred seventy-four children (mean age: 11.6 years) with autism were identified. The prevalence rate was 5.35/10,000 (16.3/10,000 if other pervasive developmental disorders are included), with no difference according to geographical area or social class. Rates of medical conditions were as follows: 1.1% for tuberous sclerosis, 2.9% for chromosomal abnormalities including fragile X, 2.9% for cerebral palsy, 4.6% for sensory impairments, 0.6% for neurofibromatosis, 0.6% for congenital rubella, and 1.7% for Down syndrome. In the combined sample of 328 children with autism, the level and pattern of medical correlates were comparable, with tuberous sclerosis having a consistently strong association with autism. Prevalence rates were similar in successive birth cohorts.
Medical disorders (excluding epilepsy and sensory impairments) accounted for fewer than 10% of the cases of autism. No secular increase in the prevalence of autism was found.
评估自闭症的患病率，评估其与特定医学疾病的关联强度，并检测其发病率是否存在长期上升趋势。
对1976年至1985年间出生且居住在法国三个不同省份的325,347名儿童进行了一项流行病学调查。从当地教育部门掌握的儿童记录中提取诊断、教育水平及相关医学状况等信息。数据还与另一项类似调查的数据进行了汇总。
共识别出174名自闭症儿童（平均年龄：11.6岁）。患病率为5.35/10,000（若包括其他广泛性发育障碍则为16.3/10,000），在不同地理区域和社会阶层间无差异。医学疾病发生率如下：结节性硬化症为1.1%，包括脆性X在内的染色体异常为2.9%，脑瘫为2.9%，感觉障碍为4.6%，神经纤维瘤病为0.6%，先天性风疹为0.6%，唐氏综合征为1.7%。在328名自闭症儿童的合并样本中，医学关联的水平和模式具有可比性，结节性硬化症与自闭症始终存在较强关联。连续出生队列中的患病率相似。
医学疾病（不包括癫痫和感觉障碍）在自闭症病例中所占比例不到10%。未发现自闭症患病率有长期上升趋势。
