【论著】甘肃省0~14岁智力低下儿童病因学研究

  09-06-15  

摘要目的了解甘肃省0~14岁智力低下(mental retardation，MR)儿童病因构成特点，为政府相关部门制定防治和干预措施提供科学依据。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，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0~14岁儿童13 958人，确诊MR的125人(不含多重)。综合残疾中兼有MR的儿童76人，合计MR儿童为201人，MR儿童的现患率(含多重)为14.40‰。农村MR儿童中受各种致病因素而致病的人数比例均高于城市；② 甘肃省0~14岁MR儿童中，病因明确者占80.60%，不明确者占19.40%。在已知的病因中，生物因素占88.27%，社会文化心理因素占11.73%；按病因的作用时间分析，出生后因素占首位，其次为产前因素。在产前因素中，无论是城市还是农村都以遗传因素为主，其次为早产、低体质量、过期产等；产后因素主要是脑疾病和社会心理因素。高热惊厥、营养不良等在农村也占有重要地位。结论加强孕期保健和产前诊断，提高产科质量，积极防治后天获得性疾病是预防MR的关键。重视小儿的早期教育，以降低MR的发病率，减轻MR的程度。防治重点应在农村。
关键词智力低下病因儿童0~14岁
The etiology of mental retardation children aged 014 in Gansu province
ZHANG Yingzhen
ABSTRACTObjectiveTo study the characteristics of the cause of the mental retardation children aged 014 in Gansu province and provide the scientific basis for the government to set down preventing and curing measures. MethodsThe study adopted the sampling method by 2phase cluster stratified. The intelligence screening and diagnoses were evaluated with standardized Gesell developmental schedule. The statistics analysis adopted SPSS13.0. Results① A total MR incidence among the children of 13 958 was 14.40‰ and the prevalence in the countryside was higher than that in the city. ② There was 80.60 percent of the sick children whose causes had been recognized, yet 19.40% could not. In the recognized disease causes, 88.27% of the factors were biological and 11.73% resulted from social psychology. The chronological analysis showed that the risk main factors were after birth and the minor were before birth. Before birth, inherit factors were the major causes both in rural and  urban areas. Besides, abortion, lower avoirdupois, delayed birth etc. also led to the above diseases . After birth, the main causes are from partial loss of the brain's function  and social and psychological factors. Hyperpyrexia, eclampsia and malnutrition were also the causes. ConclusionIt is important that to keep pregnant women healthy, medical care and examination were peformed regularly before birth to improve the birth quality, and that preventing and curing the diseases after birth immediately are keys to avoid MR. The importance should be stressed to early children's education  to reduce the prevalence of the children's MR and relieve the extent of MR. Actions should be taken medically in rural areas and enhance the cognition of MR mechanism.
KEY WORDSMental retardationcauseChildren014 years old

作者单位甘肃平凉医学高等专科学校生物学教研室