脑瘫高危因素与精神运动发育水平及MRI相关性研究  

Correlation between high-risk factors of cerebral palsy and psychomoter development level and MRI

作　　者：宋旸[1] 蒋昊翔[2] 张璐[1] 刘黎明[1] 

机构地区：[1]西安交通大学医学院第一附属医院儿保科,陕西西安710061 [2]西安市儿童医院放射科,陕西西安710002

出　　处：《中国妇幼健康研究》2013年第6期793-796,共4页Chinese Journal of Woman and Child Health Research

基　　金：西安市科技计划资助项目(HM1119)

摘　　要：目的该研究旨在通过分析脑瘫(CP)常见高危因素构成比例及其与贝利婴幼儿发育量表(BSID)中智力发育指数(MDI)及精神运动发育指数(PDI)之间的相关性,探讨高危因素对患儿智力及运动发育水平的影响。方法收集2011年7月至2012年12月期间在交大一附院儿保科就诊的0~1岁CP高危儿60例。采用BSIDⅡ评估受试对象智力与精神运动发育水平,用GE公司3.0T磁共振仪进行颅脑MRI检查。将高危因素与精神运动发育水平和MRI结果进行分析。结果 CP高危儿最常见高危因素为早产(41.67%),最常见影像学异常为脑室周围白质软化症(PVL),占46.81%。低出生体重与PVL均于早产儿多见,与足月儿相比有显著性差异(x^2值分别为14.06和4.06,均P<0.05)。BSID显示受试对象中31.67%智力发育迟滞(MDI≤69),58.33%精神运动发育迟滞(PDI≤69)。MDI与PDI评级分布区间有显著差异(x^2=11.26,P<0.01)。胎龄与PDI微弱负相关(r=-0.28,P=0.03),但与MDI无相关性(r=-0.11,P>0.05)。结论①早产作为CP常见的高危因素,常合并低出生体重;②早产较足月更容易导致PVL;③与智力障碍相比,CP高危儿运动障碍更为严重。Objective To investigate the effects of high-risk factors of cerebral palsy （CP） on psychomoter development levels by analyzing the composition ratio of high-risk factors and the correlations between these factors and the psychomoter development index （PDI） and mental development index （MD1） in Bayley Scales of Infant Development （BSID）. Methods From July 2011 to December 2013 60 infants with high risk of CP aged 0-1 year visited child health department in the First Affiliated Hospital of Xi＇ an Jiaotong University. The psyehomoter and mental development levels were assessed by BSID II, and eraniocerebral MRI examination was performed by 3.0T Scanner （GE）. The high-risk factors, psychomotor development level and MRI results were analyzed. Results Premature （41.67%） was the most common factor of high-risk CP infants, and PVL （46.81% ） was the most common imaging feature. Compared with the mature infants, the low birth weight and PVL were significantly more often in the premature infants （χ2 value was 14.06 and 4.06, respectively, both P 〈 0. 05 ）. BSID implied 31.67% of the subjects with sluggish mental development （MDI ≤69 ） and 58.33% with sluggish psychomotor development （PDI ≤69 ） , respectively. The grade of MDI and PDI was significantly different in the distribution interval （χ2 = 11.26, P 〈 0.01 ）. The fetal age was weakly negatively correlated with PDI （r = -0.28 ,P =0.03 ） , but not correlated with MDI （r=-0.11, P 〉 0.05）. Conclusion As a common high-risk factor of CP, premature is often associated with low birth weight. Compared with term delivery, premature birth is more likely to lead PVL. Movement disorders of CP high-risk infants are more severe than dysgnosia.

关 键 词：脑瘫 高危儿 贝利婴幼儿量表 磁共振成像 

分 类 号：R742.3[医药卫生—神经病学与精神病学]