早产儿全身运动质量评估等新生儿神经运动发育评估的相关性研究

Correlation analysis of assessment of general movements,neonatal behavioral neurological assessment, and 20-item neuromotor assessment in preterm infants

目的探讨早产儿全身运动质量评估(GMs)、新生儿行为神经测评(NBNA)、20项神经运动(20项)检查的相关性。方法选择2017年6月至2019年5月来咸阳彩虹医院儿童保健门诊查体的88例早产儿为研究对象,在规定时间段内接受GMs[纠正胎龄(5±1)周和(15±1)周各做1次]、NBNA(纠正胎龄1~2周)和20项检测(在纠正胎龄1个月和3~4个月时各做1次检查),分扭动阶段和不安运动阶段对三种检查方法结果进行相关性分析。结果 NBNA评估异常检出率为10.2%(9/88);20项评估结果为:纠正月龄1个月时异常检出率为34.1%(30/88),纠正月龄3~4月时异常检出率为17.0%(15/88);GMs评估结果:扭动运动阶段异常检出率为79.6%(49/88),不安运动阶段异常检出率为6.8%(6/88)。扭动阶段GMs与20项检查结果和20项与NBNA检查结果具有较低的一致性(Kappa值分别为0.232和0.300,均P<0.05),GMs与NBNA检查结果无一致性(P=0.163);不安运动阶段GMs与20项检查结果、GMs与NBNA检查结果和20项与NBNA检查结果均具有中等程度一致性(Kappa值分别为0.585、0.702和0.585,均P<0.05)。结论 GMs质量评估与NBNA、20项检查结果具有一致性。

Objective To investigate the correlation among the assessment of general movements(GMs),neonatal behavioral neurological assessment(NBNA),20-item neuromotor assessment(abbreviated as 20-item test)in preterm infants.Methods 88 preterm infants who did routine medical examination in the Children’s Health Clinic of Xianyang Rainbow Hospital during the period of June 2017 to May 2019 were selected to assess GMs(the examinations were done at corrected gestational age 5 weeks±1 week and 15 weeks±1 week),NBNA(the examination was done at corrected gestational age 1-2 weeks)and for 20-item test(the examinations were done at corrected gestational age of 1 month and 3-4 months)and correlation analysis of GMs,NBNA,20-item neuromotor assessment.Results The detection rate of abnormality in NBNA was 10.2%(9/88).The results of 20-item test were as follows:the abnormality detection rate was 34.1%(30/88)at corrected gestational age of 1 month,while the abnormality detection rate was 17.0%(15/88)at corrected gestational age of 3-4 months.The results of GMs test showed that the abnormality detection rate was 79.6%(49/88)in the writhing movement phase and 6.8%(6/88)in the abnormal movement phase.In the twisting phase,the results of GMs test and 20-item test,and 20-item test and NBNA showed lower consistency(Kappa values were 0.232 and 0.300 respectively,and P values were<0.05),and there was no consistency between GMs and NBNA(P=0.163).In the restless exercise phase,the results of GMs test and 20-item test,GMs test and NBNA,20-item test and NBNA had moderate consistency(Kappa values were 0.585,0.702,and 0.585,respectively,and P values were<0.05).Conclusion The results of GMs test,NBNA and 20-item test had consistency.