早期运动发育指标对早产儿脑性瘫痪的诊断价值

The value of earlier motion and growth index on diagnosing cerebral palsy in premature infants

目的 评价早期运动发育指标对早产儿脑性瘫痪的诊断价值 ,确定脑性瘫痪 (脑瘫 )的早期症状。方法 1997年 5～ 6月对江苏南部 7个市县 1～ 6岁儿童进行现况普查 ,详细记录脑瘫婴幼儿期的运动发育情况。结果 75 %脑瘫患儿 3、4个月俯卧位时不会抬头 ,78.2 % 5、6个月时手不会主动握物 ,89.5 % 6、7个月时不会独坐 ,92 .7% 10个月时扶物不会站 ,97.6 % 12个月时不会单独站立 ,97.6 % 15个月时不会独自走。特异度、准确度均在 91.8%以上 ,阳性预测值在 2 9.1%～ 5 6 .5 % ,阴性预测值在 99.0 %以上 ,误诊率小于8.2 %。结论 3、4个月龄俯卧位时是否会抬头是脑瘫的超早期诊断指标之一 ;5、6个月龄时手是否会主动握物和 6、7个月龄时是否会独立坐是脑瘫的早期诊断指标之一。该

Objective To analyse the value of earlier motion development growth index on diagnosing cerebral palsy in premature infants,and identify the early symptoms of cerebral palsy in premature infants.Methods A population-based investigation (1 to 6 year-old children) was conducted from May to June 1997 in southern Jiangsu province; the detailed symptoms of cerebral palsy were recorded.Results Seventy-five percent cases with cerebral palsy could not raise their heads in prone position at the age of 3 to 4 months ; 78.2 % cases had difficulty holding objects at the age of 5 to 6 months; 89.5 % cases had difficulty sitting by themselves at the age of 6 to 7 months; 92.7 % cases could not get on their feet at the age of 10 months with the help of support; 97.6 % cases could not get on their feet themselves at the age of 12 months; 97.6 % children could not walk at the age of 15 months. Specificity and accuracy amounted to 91.8 %, with positive anticipation value 29.1 %-56.5 %,the negative value 99.0 % and misdiagnostic rate less than 8.2 %.Conclusions Three criteria may be the index of early screening and diagnosing the cerebral palsy , which include holding up the head at 3 to 4 months in prone position, holding objects automatically at 5 to 6 months, and sitting on their own at 6 to 7 months.