改良神经行为学评分量表评估新生兔神经行为表现的效果  

Effect of modified passive movement test on the neurobehavioral score of neonatal rabbits

作　　者：王能里[1] 叶伟[2] 林素[1] 唐震海[1] 南燕[1] 柳艳丽[1] 林锦[3] 林振浪[1] 

机构地区：[1]温州医学院附属育英儿童医院新生儿科,325027 [2]武汉市儿童医院新生儿科 [3]美国纽约大学西奈山医学院儿科

出　　处：《中华围产医学杂志》2013年第8期505-510,共6页Chinese Journal of Perinatal Medicine

基　　金：浙江省自然科学基金（Y2101067）;浙江省科技厅钱江人才计划项目（2009R10054）;浙江省温州市科技局对外科技合作交流项目（H2008055）

摘　　要：目的研究改良的神经行为学评估结果量表对新生兔神经行为学评分的效果。方法妊娠29d健康新西兰白兔12只，随机分为3组，每组4只。缺氧缺血25min组、缺氧缺血28min组分别阻断孕兔子宫血流25、28min，对照组不阻断子宫血流。记录新生兔的一般情况。每组活产新生兔随机分为顺向评分亚组、反向评分亚组、改良评分亚组，分别按神经行为学评分量表顺向和反向顺序以及改良的神经行为学评分量表顺向顺序进行评估，记录神经行为学评分结果，比较不同评分方法对评估结果的影响。同时行病理学观察，分析存活新生兔神经行为学得分与缺氧缺血时间和脑细胞凋亡数量的相关性。采用Spearman秩相关检验、单因素方差分析、Kruskal-WallisH检验、Wilcoxon秩和检验或X^2检验进行统计学分析。结果对照组和缺氧缺血25、28min组的死胎率分别为0．0％（0／28）、16．7％（6／31）与37．9％（11／29），X^2=21．33，P=0．00；纹状体单位面积内脑细胞凋亡数量逐渐增多[分别为0（0-1）、7（6-10）与25（22-28）个，H=54．39，P〈0．05]；神经行为学得分依次降低[对照组、缺氧缺血25和28min组相比，姿势：3．00（2．25-3．00）分、2．00（1．00-2．00）分与1．00（1．00-1．00）分，H=38．47；翻正次数：9．00（8．00-9．75）次、4．00（3．00-5．00）次与1．00（0．00-1．00）次，H=52．30；翻正得分：2．90（2．80-2．98）分、2．10（1．90-2．20）分与1．30（1．00-1．40）分，H=53．53；运动能力：3．00（2．00-3．00）分、1．50（1．00-2．00）分与0．00（0．00-1．00）分，H=38．97；吮吸和吞咽协调能力：3．00（2.00-3．00）分、1．50（1．00-2．00）分与1．00（0．00-1．00）分，H=42．87；嗅觉刺激：3．00（3．00-3．00）分、2．00（2．00-2．00）分与1．00（1．00-2．00）分，H=38．43；P均=0．00]。反向评分亚组神经�Objective To study the effect of passive movement test on neurobehavioral score of neonatal rabbit and establish an improved neurobehavioral scoring protocol. Methods Twelve pregnant New Zealand white rabbits were randomly divided into three groups （n=4 in each）. In 25 and 28 min ischemic group, uterine blood supply was blocked for 25 min and 28 rain respectively, but not in the control group. The general information of neonatal rabbit was recorded. All live birth neonatal rabbits in each group were again randomly divided into forward assessment group, backward assessment group and simplified assessment group. Forward assessment group and backward assessment group were assessed with the published protocol in forward and reverse order respectively, and the simplified assessment group was assessed with improved protocol in forward order. The results of assessment was recorded and the effect of different assessment methods on neurobehavioral score was evaluated. Meanwhile, the pathohistological changes in the brains of neonatal rabbits were observed, and the correlation between the neurobehavioral test score and the duration of intrauterine ischemic and the amount of apoptosis neural cell was analyzed. Spearman rank correlation test, single factor analysis of variance, Kruskal-Wallis H test, Wilcoxon signed rank test and Chi square test were used for statistical analysis. Results The stillbirth rate in control group, 25 and 28 min iscbemic group was 0.0%（0/28）, 16.7%（6/31） and 37.9%（11/29） with statistical significance （X^2=21.33, P〈0.05）. The amount of apoptosis brain cells in the three groups was 0 （0 1）, 7 （6-10） and 25 （22- 28） respectively （X^2=54.39,P〈0.05）. Theneurobehavioral test score in control, 25 minand28 min ischemic group decreased accordingly [Posture： 3.00（2.25-3.00）, 2.00（1.00-2.00） and 1.00（1.00 1.00） （H=38.47, P=0.00）; Righting turns （times）= 9.00（8.00 9.75）, 4.00（3.00 5.00） and 1.00（0.00-1.00） （H=52.30, P=0.00）; Rightin

关 键 词：缺氧缺血 脑 运动 神经行为学表现 兔 

分 类 号：R722.1[医药卫生—儿科]