HINE联合Gesell对脑瘫高危儿早期识别的应用价值

Application value of HINE combined with skull Gesell in early recognition of high risk infants with cerebral palsy

目的 将Hammersmith婴儿神经学检查量表(HINE)和Gesell发育量表联合应用于脑瘫高危儿的早期筛查,旨在开发出更完善更高效的早期筛查方案。方法 选择台州市妇女儿童医院及台州市中心医院于2020年10月—2021年12月就诊的脑瘫高危儿80例为脑瘫高危组;另选择同期健康婴幼儿50例为对照组。比较脑瘫高危儿和健康婴幼儿HINE量表和Gesell发育量表评分;分析HINE联合Gesell发育量表对脑瘫高危儿早期识别价值。结果 脑瘫高危组颅神经[(12.94±1.81)分]、运动[(4.59±1.04)分]、姿势[(15.91±1.86)分]、反射和反应[(12.91±1.94)分]、肌张力[(21.38±2.73)分]及量表总分[(67.71±8.61)分]均低于对照组[(13.62±1.11)分、(5.32±0.62)分、(16.78±1.25)分、(13.96±1.12)分、(23.30±0.88)分、(72.98±3.36)分,均P<0.05]。脑瘫高危组应物、精细动作、粗大运动和应人DQ值低于对照组(均P<0.05),而脑瘫高危组语言DQ值比较差异无统计学意义(P>0.05)。经ROC曲线分析,HINE联合Gesell量表对脑瘫高危儿早期预测灵敏度(96.3%)和特异度(96.0%)高于HINE量表(86.3%、70.0%)与Gesell量表(87.5%、58.0%,P<0.05)。结论 HINE量表联合Gesell发育量表对脑瘫高危儿早期识别价值显著,灵敏度和特异度良好。

Objective The combined application of the Hammersmith infant neurological examination scale(HINE)and the Gesell developmental scale in early screening of high-risk infants with cerebral palsy aims to develop a more comprehensive and efficient early screening plan.Methods Select Taizhou Women's and Children's Hospital and Taizhou Central Hospital to study 80 high-risk children with cerebral palsy from October 2020 to December 2021;another 50 healthy infants and young children in the same period were selected as the control group.To compare the scores of the HINE scale and the Gesell developmental scale scores between high-risk infants with cerebral palsy and healthy infants;to analyze the early recognition value of HINE combined with Gesell developmental scale in high-risk infants with cerebral palsy.Results The high-risk cerebral palsy group had lower scores in cranial nerves[(12.94±1.81)points],motor[(4.59±1.04)points],posture[(15.91±1.86)points],reflexes and reactions[(12.91±1.94)points],muscle tone[(21.38±2.73)points]and total scale score[(67.71±8.61)points]compared to the control group[(13.62±1.11)points,(5.32±0.62)points,(16.78±1.25)points,(13.96±1.12)points,(23.30±0.88)points,and(72.98±3.36)points],the differences were statistically significant(all P<0.05).The DQ scores of reaction,fine motor,gross motor,and response were lower in the high-risk cerebral palsy group than control group(all P<0.05);while the DQ values of language in the high-risk cerebral palsy group had no statistical significance(P>0.05).By receiver operating characteristic analysis,the sensitivity(96.3%)and specificity(96.0%)of HINE combined with Gesell scale for early prediction of high risk infants with cerebral palsy were higher than those of HINE scale(86.3%,70.0%),Gesell scale(87.5%,58.0%,P<0.05).Conclusion HINE combined with the Gesell Scales of Brain Development is of great value in the early recognition of high-risk infants with cerebral palsy and can improve the diagnostic sensitivity and specificity.