孕龄与出生体质量对脑瘫患儿粗大运动功能分级影响研究

Effects of age and birth mass on grades of gross motor function in children with cerebral palsy

目的探讨孕龄与出生体质量对脑瘫患儿粗大运动功能分级系统(GMFCS)分级的影响。方法选取北部战区总医院自2017年5月至2019年5月收治的110例脑瘫患儿为研究对象。根据GMFCS分级标准,将患儿分入3组,轻度组(GMFCSⅠ~Ⅱ级)55例、中度组(GMFCSⅢ级)40例、重度组(GMFCSⅣ~Ⅴ级)15例。比较3组患儿不同孕龄比例和不同出生体质量比例。结果患儿孕龄<26周,轻度组0(0)、中度组5.0%(2/40)、重度组40.0%(6/15);孕龄26~31周,轻度组9.1%(5/55)、中度组45.0%(18/40)、重度组53.3%(8/15);孕龄32~37周,轻度组69.1%(38/55)、中度组42.5%(17/40)、重度组6.7%(1/15);孕龄>37周,轻度组21.8%(12/55)、中度组7.5%(3/40)、重度组0(0);组间两两比较,差异均有统计学意义(P<0.05)。患儿出生体质量<1000 g,轻度组0(0)、中度组10.0%(4/40)、重度组33.3%(5/15);出生体质量1000~1500 g,轻度组12.7%(7/55)、中度组37.5%(15/40)、重度组53.3%(8/15);出生体质量1500~2500 g,轻度组50.9%(28/55)、中度组40.0%(16/40)、重度组13.4%(2/15);出生体质量>2500 g,轻度组36.4%(20/55)、中度组12.5%(5/40)、重度组0(0);组间两两比较,差异均有统计学意义(P<0.05)。结论患儿孕龄越短,GMFCS分级越高;患儿出生体质量越低,GMFCS分级越高。临床上可将孕龄和出生体质量作为脑瘫患儿GMFCS分级的重要参考指标。

Objective To investigate the effects of gestational age and birth mass on gross motor function grading system(GMFCS)in children with cerebral palsy.Methods A retrospective study was performed on 110 cases of children with cerebral palsy who were admitted from May 2017 to May 2019.According to the GMFCS grading standard,the children were divided into three groups,mild group(GMFCS levelⅠ-Ⅱ)55 cases,moderate group(GMFCS levelⅢ)40 cases,the severe group(GMFCSⅣ-Ⅴ)15 cases.The ratios of different gestational ages and different birth mass were compared among the 3 groups.Results Gestational age of the children<26 weeks was 0(0)in the mild group,5.0%(2/40)in the moderate group,and 40.0%(6/15)in the severe group.Gestational age from 26 to 31 weeks was 9.1%(5/55)in the mild group,45.0%(18/40)in the moderate group,and 53.3%(8/15)in the severe group.Gestational age from 32 to 37 weeks was 69.1%(38/55)in the mild group,42.5%(17/40)in the moderate group,and 6.7%(1/15)in the severe group.Gestational age>37 weeks was 21.8%(12/55)in the mild group,7.5%(3/40)in the moderate group,and 0(0)in the severe group.Pairwise comparisons between groups showed statistically significant differences(P<0.05).The birth body mass of the children<1000 g was 0(0)in the mild group,10.0%(4/40)in the moderate group,and 33.3%(5/15)in the severe group.The birth body mass ranged from 1000 g to 1500 g was 12.7%(7/55)in the mild group,37.5%(15/40)in the moderate group,and 53.3%(8/15)in the severe group.The birth body mass ranged from 1500 g to 2500 g was 50.9%(28/55)in the mild group,40.0%(16/40)in the moderate group,and 13.4%(2/15)in the severe group.The birth body mass>2500 g was 36.4%(20/55)in the mild group,12.5%(5/40)in the moderate group,and 0(0)in the severe group.Pairwise comparisons between groups showed statistically significant differences(P<0.05).Conclusion The shorter the gestational age,the higher the GMFCS,the lower the birth body mass and the higher the GMFCS.Gestational age and birth body mass can be used as important research indexes of GMFCS for children with cerebral palsy.