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摘要
现有证据表明,环境因素可能对自闭症谱系障碍(ASD)风险变异的贡献率高达50%。这篇结构化的叙述性综述提供了对ASD环境风险因素的现有知识的全面综合,包括对相互矛盾的证据的评估,潜在机制的探索以及对未来研究方向的建议。各种流行病学调查的分析表明,某些环境因素,包括父母高龄、早产、分娩并发症、暴露于有毒金属、药物、空气污染物和内分泌干扰化学物质,通过各种机制(如氧化应激、炎症、缺氧及其后果、神经递质改变、信号通路中断等)与ASD风险增加有关。另一方面,与妊娠相关的因素,如产妇糖尿病、产妇肥胖、剖腹产与ASD风险的相关性较弱。与此同时,其他环境因素,如疫苗接种、母亲吸烟或饮酒,与自闭症的风险无关。关于营养元素的数据尚无定论。这些发现强调了环境因素在ASD病因学中的重要性,并强调需要针对ASD的危险因素进行更有针对性的研究。针对可改变的危险因素的环境干预可能为ASD的预防和治疗提供有希望的途径。
关键词: 自闭症谱系障碍,流行病学,危险因素,环境因素,有毒金属,怀孕。
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