新生儿脑室周围白质软化发生脑性瘫痪的危险因素分析  

An analysis of risk factors for cerebral palsy in newborns with periventricular leukomalacia

作　　者：战美丽[1] 王长芹[1] 李书芹[1] 王会芹[1] 张秀卿[1] 徐桂霞[1] 李洪双[1] 

机构地区：[1]山东省聊城市第二人民医院新生儿科,252601

出　　处：《中华全科医师杂志》2008年第2期90-93,共4页Chinese Journal of General Practitioners

摘　　要：目的探讨新生儿脑室周围白质软化（PVL）发生脑性瘫痪（脑瘫）的危险因素。方法对2000年12月至2005年11月我院806例新生儿中遗留脑瘫后遗症的患儿61例进行病因研究。经至少2次头颅B超或MRI确诊、并已排除其他疾病的26例PVL患儿为PVL组，取同期住院的35例非PVL所致的脑瘫患儿为非PVL组，并对PVL的高危因素进行回归分析。结果PVL26例，占脑瘫病因的42．6％。重度窒息（x3）、低孕周（x1）、颅内出血（x14）、低血压（x8）是PVL发生的高危因素，其OR值分别为2．843、3．575、3．268、1．947，建立的主效应模型为logistic（P）=β0＋0．7952x3—1．428x1-1．328x14＋0．8256x8。妊娠期高血压疾病、新生儿呼吸窘迫综合征、宫内感染对PVL的发生也有影响（P〈0．05）。结论PVL是发生脑瘫的主要病因之一，重度窒息、低孕周、颅内出血、低血压是PVL发生脑瘫的主要高危因素。Objective To investigate the risk factors of cerebral palsy in newborns with periventricular leukomalacia （PVL）. Methods Sixty-one infants with sequela of cerebral palsy among 806 neonates born at the Second People＇s Hospital of Liaocheng, Shandong, China, during December 2000 to November 2005 were studied for its etiology. Diagnosis of cerebral palsy in 26 of the 61 infants was established by type B ultrasonic scanning or magnetic resonance imaging （MRI） for the head at least twice and excluded of other diseases. Thirty-five infants without PVL hospitalized at the same hospital were enrolled as control group during the same period. Logistic regression analysis was performed for the risk factors of PVL Results Twenty-six infants were diagnosed as PVL, accounting for 42. 6% of those with cerebral palsy. Main high-risk factors of PVL included severe asphyxia （ x3 ）, low gestational age （x1 ）, intraventricular hemorrhage （x14） and low blood pressure （xs ）, with odds ratios of 2. 843, 3. 575, 3. 268 and 1. 947, respectively, and a fitted regression model as logistic （P） = 13o ＋ 0. 7952 x3 -1. 428 x1 - 1. 328 x14 ＋ 0. 8256 x8. Pregnant hypertension, neonate respiratory distress syndrome （NRDS）, and intrauterine infection could also affect occurrence of PVL, all with statistical significance （ P 〈 0. 05 ）. Conclusion PVL is one of main causes of cerebral palsy, with severe asphyxia, low gestational age, intraventricular hemorrhage and low blood pressure as main high-risk factors.

关 键 词：婴儿 新生 白质软化病 脑室周围 脑性瘫痪 

分 类 号：R742[医药卫生—神经病学与精神病学]