吉林地区3万0～6岁散居儿童脑性瘫痪流行病学调查

The epidemiological investigation of 30 000(0～6-years-old)live scattered children patients of cerebral palsy in jilin area

目的:调查小儿脑性瘫痪(CerebralPalsy,简称CP)的发病率 ,临床分类及影响CP的高危因素。方法 :把吉林地区被调查的0～6岁儿童划分为三个不同区域 ,即市区、化工区、农牧区 ,共调查30876人。用统一计划、统一表格 ,统一标准化的国际通行调查方法。结果 :经过二年的调查研究和定群随访 ,新诊断CP患儿56例。农牧区发病率为3.5‰ ,化工区为2.4‰ ,市区为1.3‰ ,总发病率为1.8‰。不同的区域间有显著差异(P<0.01)。各年龄组发病率为～6个月4例(7.2 %)、～1岁7例(12.4%)、～3岁37例(66.1 %) ,～6岁8例(14.3 %)。不同年龄组的发病率有显著差异。对CP的20余种高危因素的调查 ,经Logistic多元回归分析发现 ,最多见的高危因素依次为 :新生儿窒息、早产、低体重、双胞胎、颅内出血和核黄疸。而16 %的患儿无明显病因。结论 :医疗条件较差的农牧区CP的发病率远高于市区。目前我国CP的早期诊断仍比较落后 ,56例患者中仅占4例(7.2 %) ,这与发达国家早期诊断率40 %～60 % ,相差甚远。本调查对目前我国CP的发病率 ,不同高危因素对CP发病的影响以及CP的分类 ,提供了科学的理论依据。

Objective:Investigating the incidence,the clinical classification and the influential dangerous factors of CP.Methods:The investigated 0～6yearsold children amout to 30 876 in JiLin area,who were divided into three groups,the city area,the chemical industry area and the farming and stock breeding area,Utilizing the international current investigation method of the unified plan,the unified form and the unified standardization.Results:In the light of the investigation and followup in a certain group for two years,the newly diagnosed children add up to 56 cases.The incidence of CP is 3.5‰in the farming and stock breeding area,2.4‰in the chemical industry area,1.3‰in the city proper and 1.81‰on the whole,which show obvious diversity in different areas.The age incidences are as the follows,4 cases of ～6 months(7.2%),7 cases of ～1 years old(12.4%),37 cases of ～3 years old(66.1%),8 cases of ～6 years old(14.3%),which show obvious diversity in different age groups.By means of investigating twenty kinds of dangerous factors and as result of the logistic polyatomic regression analysis,the order of the most dangerous factor is asphyxia of newborn,premature infant,low weight,twins,intacranial hemorrhage and nuclear janndice,but 16 percent patients have no clear cause.Conclusion :The incident in the farming and stock breeding with worse medical conditions is higher than which in the city area.The early diagnosis of CP in our country is inferioronly 4 cases in 56 caseswhich far behind the developed country where early diagnosis rate is 40%～60%.This investigation provides scientific theory basis for the incidence of CP in our country,the influence on CP with the different high risk factors and the CP classification.