早产儿胼胝体生长率与运动发育迟滞关系的研究

Relationship between the growth rate of corpus callosum and neuromotor delay in premature infants

目的研究早产儿胼胝体生长率与神经运动发育之间的关系。方法2007年3～8月入住新生儿重症监护病区胎龄小于34周早产儿50例,于生后0～6周接受经前囟门矢状位颅脑超声探查,胼胝体长度测量为从膝部至压部。所有早产儿于校正胎龄3月时接受52项神经运动检查,分析胼胝体生长率与神经运动检查结果之间的关系。结果早产儿出生时的胼胝体平均长度为39.16mm,生后头6周,胼胝体生长率平均1.05mm/周;神经运动检查异常组早产儿(n=14)和神经运动检查正常组早产儿(n=36)0～2周胼胝体生长率差异无显著性意义,P>0.05,但神经运动检查异常组早产儿2～3周和4～5周胼胝体生长率(0.68mm/周和0.86mm/周)慢于正常组早产儿(1.17mm/周和1.12mm/周),差异有显著性意义(P<0.05),合并2～6周总的生长率,异常组仍然慢于正常组(0.91mm/周比1.15mm/周),差异有显著性意义(P<0.01)。结论床旁超声监测早产儿胼胝体生长发育切实可行,早产儿于校正胎龄3月时神经运动发育迟滞可能与2～6周龄时胼胝体生长率低下有关。

Objective To study the relationship between the growth rate of the corpus callosum and neurological motor development in premature infants. Methods Fifty infants whose gestational ages were less than 34 weeks and who were admitted to the neonatal intensive care unit from March 2007 to August 2007 were enrolled. From 0 to 6 weeks of postnatal age, the sagittal midline cranial sonography via anterior fontanel was performed, once weekly. The length and the morphology of the corpus callosum were measured. The 52-neuromotor examinations were performed at 3 months of corrected gestational age. Results The mean length of the corpus callosum was 39.16 mm at birth. The mean growth rate of the corpus callosum during the first 6 weeks of life was 1.05 mm/week. Fourteen infants showed abnormal neuromotor development and 36 had normal neuromotor function at 3 months of corrected gestational age. A decreased growth rate of the corpus callosum was observed in the abnormal nervimotion group between 2 and 3 weeks （0.68 ram/week vs 1.17 mm/week） and between 4 and 5 weeks （0.86 rant/week vs 1. 12 mm/week） after birth compared with that in normal nervimotion group （ P 〈 0.05 ）. The total growth rate of the corpus callosum from 2 to 6 weeks after birth in the abnormal nervimotion group was also lower than that in the normal nervimotion group （0. 91 ram/week vs 1. 15 mm/week; P 〈 0.01 ）. Conclusions A neuromotor delay at 3 months of corrected gestational age may be associated with the decreased growth rate of the corpus callosum between 2 and 6 weeks of life in premature infants.