不同胎龄及出生体质量早产儿早期神经发育的纵向研究  

Longitudinal study of early neural development in premature infants with different gestational age and birth weight

作　　者：闫淑媛[1] 刘震宇[2] 钱红艳[1] 匡晓妮[1] 喻钟 谭琳[1] 夏蝉[1] 

机构地区：[1]长沙市妇幼保健院儿童保健中心,湖南长沙410007 [2]湖南省人民医院儿童医学中心,湖南长沙410005

出　　处：《临床儿科杂志》2017年第6期425-429,共5页Journal of Clinical Pediatrics

摘　　要：目的探讨早产儿早期神经发育趋势。方法随访早产儿及足月儿于12、24月龄时(早产儿为校正年龄),以Bayley婴幼儿发育量表评估的智力发育指数(MDI)及运动发育指数(PDI)的差异。结果 12月龄时,出生胎龄<32周、32~33^(+6)周、34~36^(+6)周早产儿各组与足月儿组之间按校正年龄(CA)的PDI得分差异无统计学意义(P=0.820);足月儿和出生胎龄34~36^(+6)周组按实际年龄(UCA)的MDI和PDI得分均高于<32周和32~33^(+6)周组,足月儿组的PDI得分高于34~36^(+6)周组,差异均有统计学意义(P<0.05)。不同出生体质量早产儿与足月儿组之间按CA的PDI得分比较差异无统计学意义(P=0.166),≥2 500 g早产儿及足月儿组按UCA的MDI和PDI得分高于出生体质量<1 500 g、1 500~1 999 g及2 000~2 499 g早产儿组,差异均有统计学意义(P<0.05)。24月龄时,按UCA的MDI得分足月儿组高于出生胎龄<32周、32~33^(+6)周、34~36^(+6)周早产儿组,也高于出生体质量<1 500 g、1 500~1 999 g及2 000~2 499 g早产儿组,差异均有统计学意义(P<0.05)。<1 500g早产儿组按UCA的MDI曲线呈下降趋势,而按UCA的PDI曲线呈明显上升趋势。结论早产儿CA12月龄、24月龄时神经发育基本达同龄足月儿水平。ObjectiveTo investigate the trend of early neural development in premature infants. MethodsAt the age of 12 months and 24 months, Bayley Scales of Infant Development were used to assess the mental development index （MDI） and the psychomotor development index （PDI） in preterm （corrected age） and full-term infants. ResultsAt 12 months, there was no signifcant difference in corrected age PDI scores among different gestational age groups （〈32 , 32？33＋6 and 34？36＋6 weeks） （P=0.820）. The actual age MDI and PDI scores of full-term infants and premature infants in 34-36＋6 weeks group were signifcantly higher than those of premature infants in 〈32 and 32-33＋6 weeks groups, and the PDI score of full-term infants was signifcantly higher than that of premature infants in 34-36＋6 weeks group （P〈0.05）. There was no signifcant difference in actual age PDI scores among different birth weight groups （P=0.166）. The actual age MDI and PDI of full-term infants and premature infants in birth weight ≥2500 g group were signifcantly higher than those of premature infants in 〈1500 g, 1500~1999 g and 2000~2499 g groups （P〈0.05）. At 24 months, the actual age MDI scores of full-term infants were signifcantly higher than those of premature infants in different gestational age and birth weight groups （P〈0.05）. The actual age MDI curve of premature infants in birth weight 〈1 500g group showed a downward trend, while the actual age PDI curve showed a signifcant upward trend. ConclusionThe neurodevelopment of preterm infants at the corrected age of 12 and 24 months reaches the level of full-term infants.

关 键 词：早产儿 胎龄 出生体质量 神经发育 Bayley婴幼儿发育评估量表 

分 类 号：R722.6[医药卫生—儿科]