3~6月龄婴儿Hammersmith婴儿神经检查最优评分影响因素分析

Influencing factors of optimal score of Hammersmith Infant Neurological Examination in infants aged 3 to 6 months

目的 分析影响3~6月龄婴儿Hammersmith婴儿神经检查(HINE)最优评分的相关因素,为早期干预介入提供相关依据。方法 选取2019年8月—2021年2月在吉林大学第一医院发育行为儿科接受HINE评估的3~6月龄婴儿145例,其中正常组70例,异常组75例。将可能影响HINE最优评分的孕期及围生期的22种相关影响因素进行调查。结果 异常组胎儿宫内窘迫、羊水异常、出生窒息、颅内出血、新生儿惊厥发生率明显高于正常组(χ^(2)=6.24、6.05、5.51、12.91,P<0.05)。多元Logistic回归分析显示,羊水异常(OR=3.38,95%CI:1.38~8.29)、颅内出血(OR=4.09,95%CI:1.59~10.49)、新生儿惊厥(OR=11.62,95%CI:2.43~55.55)是3~6月龄婴儿HINE最优评分的独立影响因素(P<0.05)。结论 应对围生期存在羊水异常、颅内出血、新生儿惊厥的小婴儿给予早期筛查和干预。

Objective To analyze the related factors affecting the optimal score of Hammersmith Infant Neurological Examination(HINE) of 3-to 6-month-old infants, so as to provide basis for early intervention. Methods A total of 145 infants aged 3 to 6 months who received HINE evaluation in the Department of Developmental Behavior Pediatrics, the First Hospital of Jilin University from August 2019 to February 2021 were selected, including 70 infants in normal group and 75 infants in abnormal group. A total of 22 related factors that may affect the optimal score of HINE during pregnancy and perinatal period were investigated. Results The prevalence rates of intrauterine distress, amniotic fluid abnormality, birth asphyxia, intracranial hemorrhage and neonatal convulsion in abnormal group were significantly higher than those in normal group(χ^(2)=6.24, 6.05, 5.51, 12.91, P<0.05). Multiple Logistic regression analysis showed that amniotic fluid abnormality(OR=3.38, 95%CI:1.38-8.29), intracranial hemorrhage(OR=4.09, 95%CI:1.59-10.49) and neonatal convulsion(OR=11.62, 95%CI:2.43-55.55) were independently risk factors for the optimal score of Hammersmith Infant Neurological Examination(HINE)(P<0.05). Conclusion Early screening and intervention should be given to infants with amniotic fluid abnormality, intracranial hemorrhage and neonatal convulsion.