全身运动评估对极低出生体重早产儿运动发育结局的预测价值  

Predictive value of qualitative assessment of general movements for motor developmental outcome of very low weight premature infant

作　　者：陈鸣[1] 杨红[1] 侯方华[1] 史惟[1] 邹婧 曹云[3] 王艺[4] 朱晓芸[1] 骆丹丹[1] 朱默[1] 邵肖梅[3] 

机构地区：[1]复旦大学附属儿科医院康复科,上海201102 [2]昆山市康复医院儿童康复科,江苏昆山215314 [3]复旦大学附属儿科医院新生儿科,上海201102 [4]复旦大学附属儿科医院神经科,上海201102

出　　处：《中国儿童保健杂志》2012年第12期1067-1069,1073,共4页Chinese Journal of Child Health Care

基　　金：2012年度上海市自然科学基金面上项目(12ZR1403600)

摘　　要：【目的】研究全身运动(general movements,GMs)评估对于极低出生体重早产儿运动发育结局的预测价值。【方法】对2007年7月-2011年6月66例在康复科随访的极低体重早产儿进行全身运动评估,在纠正月龄12月龄以后根据临床诊断和Peabody运动发育量表确定其运动发育结局。计算全身运动评估的敏感度、特异度、阳性预测值和阴性预测值。【结果】全身运动评估对于异常运动发育结局(脑瘫和运动发育迟缓)的预测效度为敏感性100%、特异性98.3%,阳性预测值87.5%,阴性预测值100%。全身运动评估对于脑瘫的预测效度为敏感性100%、特异性92.1%,阳性预测值37.5%,阴性预测值100%。【结论】GMs评估对于极低出生体重早产儿的运动发育结局具有很好的预测效度,作为新型神经运动评估手段,对于极低出生体重早产儿的临床随访具有重要意义,适合在我国进一步应用和推广。To study the predictive value of qualitative assessment of general movements （GMs） for very low birth weight （VLBW） premature infants＂ motor developmental outcome. [Methods] Neurological outcomes were de- termined at least after 12-month-old of age, according to clinical diagnoses and Peabody Developmental Motor Scale-2 （PDMS-2）. Sensitivity, specificity,positive predictive value and negative predictive value were calculated. [Results] The predictive value of GMs assessment for abnormal motor developmental outcome was as following： sensitivity 100 %,specific- ity 98.3 %, positive predictive value 87.5 ~, and negative predictive value 100 % ;The predictive value of GMs assessment for cerebral palsy was as following： sensitivity 100% ,specificity 92.1 %, positive predictive value 37.5 ~%, and negative predic- tive value 100%. [Conlusions] The qualitative assessment of GMs has a very good predictive value for VLBW infants in detecting later neurological outcomes. As a new method of neurological assessment, the qualitative assessment of GMs stands an important ground for follow-ups, and needs further application and generalization in China.

关 键 词：全身运动评估 运动发育结局 脑性瘫痪 预测效度 极低出生体重 

分 类 号：R722[医药卫生—儿科]