全身运动细化评分在早产儿脑损伤早期评估中的作用  

Role of general movement optimality scores in early assessment of premature infants with brain injury

作　　者：吕媛 任素伟 林春 李榕 李文康 陈雨天 侯玮玮 LYU Yuan;REN Suwei;LIN Chun;LI Rong;LI Wenkang;CHEN Yutian;HOU Weiwei(Pediatric Department,Clinical College of Yangzhou University,Subei People′s Hospital of Jiangsu Province,Yangzhou,Jiangsu,225000;Rehabilitation Medicine Department,Clinical College of Yangzhou University,Subei People′s Hospital of Jiangsu Province,Yangzhou,Jiangsu,225000;Dalian Medical University,Dalian,Liaoning,116044)

机构地区：[1]扬州大学临床医学院/江苏省苏北人民医院儿科,江苏扬州225000 [2]扬州大学临床医学院/江苏省苏北人民医院康复医学科,江苏扬州225000 [3]大连医科大学,辽宁大连116044

出　　处：《实用临床医药杂志》2022年第12期29-32,共4页Journal of Clinical Medicine in Practice

基　　金：苏北人民医院院扶持技术项目(fcjs2017028,fcjs2017042)。

摘　　要：目的 探讨全身运动细化评分(GMOS)在早产儿脑损伤早期评估中的作用。方法 回顾性分析完善头颅影像学及行全身运动(GMs)质量整体评估的175例早产儿资料,根据影像学资料将其分为脑损伤组(n=92)和非脑损伤组(n=83)。根据胎龄将上述2组早产儿分为<32周组(n=66)和32~36周组(n=109)。比较2组一般资料、GMs整体评估异常率和GMOS。采用受试者工作特征(ROC)曲线分析GMOS对早产儿脑损伤早期评估的效能。结果 2组男性占比、剖宫产占比比较,差异有统计学意义(P<0.05)。2组GMs整体评估结果比较,差异无统计学意义(χ^(2)=0.25,P=0.617)。非脑损伤组GMOS为27.0(25.0,29.0)分,高于脑损伤组的24.5(23.0,27.0)分,差异有统计学意义(P<0.001)。在<32周组和32~36周组中,非脑损伤早产儿GMOS均高于脑损伤早产儿,差异有统计学意义(P<0.05)。GMOS早期评估早产儿脑损伤的曲线下面积(AUC)为0.680,最佳阈值为25.5分,灵敏度为0.675,特异度为0.652,约登指数为0.327。结论 GMOS简便、可行,可作为早产儿脑损伤的一项评估手段。Objective To investigate the role of general movement optimality scores(GMOS) in early assessment of premature infants with brain injury. Methods Data of 175 premature infants who received cranial imaging and general movements(GMs) general evaluation were retrospectively analyzed,and were divided into brain injury group(n=92) and non-brain injury group(n=83)according to imaging data. According to gestational age,preterm infants were divided into <32 weeks group(n=66) and 32 to 36 weeks group(n=109). Basic conditions of the two groups were compared and difference of GMOS between them were analyzed. General data,GMs global assessment abnormal rate and GMOS score were compared between the two groups. Receiver operating characteristic(ROC) curve was used to analyze the efficacy of GMOS in early assessment of premature brain injury. Results There were statistically significant differences in proportion of male and cesarean section proportion between the two groups(P<0.05). There was no significant difference in GMs assessment between the two groups(χ^(2)=0.25,P=0.617). The GMOS of the non-brain injury group was 27.0(25.0,29.0) points,which was significantly higher than 24.5(23.0,27.0) points of the brain injury group(P<0.001). In the <32 weeks group and 32 to 36 weeks group,the GMOS of the premature infants without brain injury was significantly higher than that of the premature infants with brain injury( P < 0. 05).The area under the curve( AUC) of GMOS for early assessment of premature brain injury was0. 680,the optimal threshold was 25. 5 points,the sensitivity was 0. 675,the specificity was 0. 652,and the Yoden index was 0. 327. Conclusion GMOS is simple and feasible,and can be used as an evaluation method for premature brain injury.

关 键 词：全身运动细化评分 早产儿 脑损伤 早期评估 神经系统 

分 类 号：R722.6[医药卫生—儿科] R651[医药卫生—临床医学]