脑瘫儿童粗大运动功能分级与孕龄及出生体质量的关系  

Relationship between gross motor function classification system and gestational week as well as low birth weight in children with cerebral palsy

作　　者：马丹[1,2] 石薇[1,2] 石娅娅 王秋[1,2] 李娜[1,2] 王芳芳[1,2] 罗蓉[1,2] 

机构地区：[1]四川大学华西第二医院儿科教研室,成都610041 [2]四川大学华西第二医院神经康复科,成都610041 [3]四川大学华西公共卫生学院,成都610041

出　　处：《中华妇幼临床医学杂志（电子版）》2015年第1期18-22,共5页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：四川省科技厅科技支撑项目(2012SZ0134);四川省卫生和计划生育委员会科研基金项目(120255)~~

摘　　要：目的探讨脑瘫儿童粗大运动功能分级与其出生体质量、分娩孕龄的关系。方法采用中文版脑瘫儿童粗大运动功能分级系统（GMFCS）于2013年3-4月对成都市20个区、市、县残疾人联合会登记在册的333例2-12岁脑瘫患儿进行评定,并对粗大运动功能分级与脑瘫患儿出生体质量、分娩孕龄的关系进行统计学分析。本研究遵循的程序符合四川大学华西第二医院人体试验委员会制定的伦理学标准,得到该委员会批准。结果本组333例脑瘫患儿中,轻度脑瘫（GMFCSⅠ-Ⅱ级）、中度脑瘫（GMFCSⅢ）及重度脑瘫（GMFCSⅣ-Ⅴ级）各为149例、82例、102例。各年龄段脑瘫患儿的粗大运动功能分级比较,差异无统计学意义（χ2=4.906,P〉0.50）。其中,185例（55%）孕龄〈36孕周的早产脑瘫患儿中,轻度脑瘫（GMFCSⅠ-Ⅱ级）为74例,中、重度脑瘫（GMFCSⅢ-Ⅴ级）为111例;150例（46%）低出生体质量（〈2 500g）脑瘫患儿中,轻度脑瘫（GMFCSⅠ-Ⅱ级）为58例,中、重度脑瘫（GMFCSⅢ-Ⅴ级）为92例。本组患儿中,分娩孕龄越短,出生体质量越轻,越倾向于发展成GMFCSⅢ-Ⅳ级脑瘫（χ2=13.833,16.276;P=0.032,〈0.05）。结论分娩孕龄越短,出生体质量越轻,越倾向于发展成GMFCSⅢ-Ⅳ级脑瘫。由孕龄和出生体质量可初步预测脑瘫患儿粗大运动功能损伤的严重程度。Objective To investigate the relationship between gross motor function classification and gestational week as well as low birth weight in children with cerebral palsy. Methods From March to April 2013, a total of 333 children with cerebral palsy aged 2-12 years old in Chengdu were selected into this study, and their gross motor function classification were measured by gross motor function classification system （GMFCS, Chinese edition）. Data about children＇s gestational age and birth weight were collected. Relationship of gross motor function elassfication between gestational age and birth weight were analyzed by statistical method. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of West China Second University Hospital, Sichuan University. Informed consent was obtained from the parent of each participating child. Results Among 333 cases with cerebral palsy, mild cerebral palsy （GMFCS Ⅰ-Ⅱ grade）, moderate cerebral palsy （GMFCS Ⅲ grade） and severe cerebral palsy （GMFCS Ⅲ-Ⅴ grade） were 149 cases, 82 cases and 102 cases, respectively. There were no significant differences among the gross motor function classifications of children with cerebral palsy in different ages （X^2 = 4. 906, P〉0.50）. Among the 185 cases （55%） of preterm children （gestational age 〈36 weeks） with cerebral palsy, 74 cases were mild cerebral palsy （GMFCS Ⅰ-Ⅱ grade）, 111 cases were moderate and severecerebral palsy （GMFCS Ⅲ-Ⅴ grade）; and among the 150 cases （46%） of low birth weight （〈2 500 g） children with cerebral palsy, 58 cases were mild cerebral palsy （GMFCS Ⅰ-Ⅱ grade）, 92 cases were moderate and severe cerebral palsy （GMFCS Ⅲ-Ⅴ grade）. The shorter the gestational weeks is, and the lower the birth weight is, the more GMFCS Ⅲ-Ⅴ grade were, and there were significant differences （X^2= 13. 833, 16. 276 ; P = 0. 032, 〈0. 05）. Conclusions There is correlation between gross motor function classfication and gest

关 键 词：脑性瘫痪 粗大运动功能分级系统 孕龄 出生体质量 儿童 

分 类 号：R742.3[医药卫生—神经病学与精神病学]