Griffiths发育评估量表与Gesell发育诊断量表在细菌性脑膜炎婴儿发育评估中的一致性研究

Consistency study of Griffiths mental development scales-Chinese version and Gesell developmental schedules in the developmental evaluation of infants with bacterial meningitis

目的探讨Griffiths发育评估量表——中文版(Griffiths mental development scales-Chinese version,GDS-C)与Gesell发育诊断量表(Gesell developmental schedules,简称Gesell量表)在细菌性脑膜炎婴儿发育评估中的一致性。方法选取2018年9月至2019年12月首都医科大学附属北京儿童医院保健中心进行出院后发育监测的细菌性脑膜炎患儿41例,分别进行GDS-C与Gesell量表评估,将GDS-C各领域分别与Gesell量表相应能区进行分析比较,评估其一致性。结果GDS-C量表各领域所得百分数值与Gesell量表各能区发育商的相关性分析表明,各组间相关系数高而显著,r值分别为0.945、0.922、0.851、0.924和0.842,差异有统计学意义(P<0.01);两种量表所测各领域智龄结果表明,GDS-C在D(精细动作)和E(适应性)领域所测得智龄高于Gesell量表[(5.98±2.53)个月比(5.76±2.50)个月,(6.02±2.52)个月比(5.87±2.50)个月],差异有统计学意义(P<0.05),其余各个领域的差异无统计学意义;两量表智龄差值的绝对值≤0.5个月的比例在各领域不同,A(运动)为85.4%(35/41),B(个人-社交)为78.0%(32/41),C(语言)为78.0%(32/41),D(精细动作)为63.4%(26/41),E(适应性)为85.4%(35/41);两量表智龄差值的绝对值≤1.0个月的比例达90.2%~100.0%;两量表在A~E各领域诊断迟缓的Kappa值分别为0.851、0.688、0.796、0.678和0.775(P均<0.01),提示两种测试工具在A、C和E领域一致性较好,在B和D领域的一致性一般。结论GDS-C与Gesell量表在细菌性脑膜炎患儿发育评估中有较好的一致性,值得临床推广。

Objective To explore the consistency of Griffiths mental developmental scales-Chinese version(GDS-C and Gesell developmental schedules(Gesell scale)in the developmental assessment of infants with bacterial meningitis.Methods A total of 41 infants with bacterial meningitis who voluntarily participated in the follow-up after discharge were assessed by GDS-C and Gesell scale from September 2018 to December 2019.The fields of GDS-C were analyzed and compared with the corresponding function zones of the Gesell scale to assess their consistency.Results The correlation analysis between the percentage values obtained in each field of the GDS-C scale and the development quotient of each function zone of the Gesell scale showed that the correlation coefficients between the groups were high and significant(r=0.945,0.922,0.851,0.924 and 0.842,respectively,all P<0.01).The intelligence ages measured by GDS-C in D(fine motor)and E(adaptive ability)fields were higher than those of Gesell scale[(5.98±2.53)months vs.(5.76±2.50)months,(6.02±2.52)months vs.(5.87±2.50)months,P<0.05],and there were no statistically significant differences in other fields.The proportion of absolute value of intelligence age difference≤0.5 month in A(gross motor)was 85.4%(35/41),B(personalsocial)was 78.0%(32/41),C(language)was 78.0%(32/41),D(fine motor)was 63.4%(26/41),E(adaptive ability)was85.4%(35/41).The proportion of absolute value of intelligence age difference between the two scales≤1.0 month was90.2%-100.0%.Kappa values of the two scales in the diagnosis of delay in each field were 0.851,0.688,0.796,0.678 and0.775,suggesting that the two scales had good consistency in A(gross motor),C(language),E(adaptive ability),and had generally consistency in B(personal-social)and D(fine motor domains).Conclusions The GDS-C and Gesell developmental scale have good consistency in the evaluation of the development of infants with bacterial meningitis and are worthy of clinical promotion.