不安运动的评估对高危新生儿运动发育的预测价值  

The predictive value of qualitative fidgety movements assessment for motor development in high risk neonates

作　　者：石琳[1] 李明[1] 边旸[1] 周丛乐[1] 

机构地区：[1]北京大学第一医院儿科,100034

出　　处：《中国新生儿科杂志》2008年第6期321-324,共4页Chinese Journal of Neonatology

基　　金：首都医学科研发展基金项目(2003-3001)

摘　　要：目的评估高危新生儿不安运动(FMs)对运动发育结局的早期预测价值。方法随访高危新生儿39例,矫正日龄6～20周记录FMs,10～18月进行Gesell发育量表或丹佛发育筛查量表评估,结合婴儿神经系统检查确定发育结局。结果FMs正常的33例中随访诊断运动发育迟缓1例;未出现FMs的6例中,随访诊断脑性瘫痪4例,全面发育迟缓2例。FMs评估预测脑性瘫痪敏感度为100%,特异度为94%,阳性预测值为67%,阴性预测值为100%。预测运动发育迟缓的敏感度为86%,特异度为100%,阳性预测值为100%,阴性预测值为97%。结论FMs缺乏是早期预测脑性瘫痪良好而可靠的指标。矫正年龄10～14周单次FMs评估对运动发育也具有良好的预测价值,但对脑性瘫痪的阳性预测值较低。Objective To demonstrate the predictive value of qualitative fidgety movements assessment for motor development in high risk neonates. Methods Thirty nine high-risk infants had been followed up. Fidgety movements recordings were collected during the period of corrected age 6 - 20 weeks. Neurological outcome was determined between 10-months to 18-months of age. Gesell Developmental Scale, Denver Development Screening Test Questionnaire and neurological examination were adopted to evaluate their developmental outcome. Results Among 33 infants with normal fidgety movements, one was diagnosed as mild motor delay. Six infants were not identified with fidgety movements. Among them, 4 infants were diagnosed as cerebralpalsy, and 2 infants as global delay. In fidgety movements period, predictive validity for the motor delay was as followings： sensitivity （SEN） 86%, specificity （SPE） 100%, positive predictive value （PPV） 100%, and negative predictive value （NPV） 97%; and the predictive validity for cerebral palsy was SEN 100%, SPE 94%, PPV 100%, and NPV 100%. Conclusion Absence of fidgety movements has a good predictive value for the early identification of cerebral palsy. One record of fidgety movements during the period of corrected age of 10 - 14 weeks also has a good predictive value for the motor developmental outcome, but has lower positive predictive value for cerebral palsy.

关 键 词：发育障碍 不安运动 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]