抽样调查95435名儿童发生脑性瘫痪的危险因素

Sampling surrey of risk factors of pedo-cerebral palsy's occurrence on 95 435 children

目的:探讨导致脑性瘫痪(脑瘫)的危险因素,为有效预防脑瘫提供科学依据。方法:对河北省6县、市以乡(镇)为单位进行整体抽样,对抽取的41个样本乡(镇)全部1～6岁的95435名儿童进行脑性瘫痪调查。采用1:比例进行病因调查。结果:共检出脑性瘫痪患者171名。患病率为1.77‰。经Logistic回归分析,筛选出13个有显著意义的因素。母亲的文化程度、家庭经济收入和出生体质量是保护性因素(回归系数是负数,分别为-0.414-1.667,-0.000657,P<0.05～0.01),母亲的文化程度、家庭经济收入和出生体质量越高,发生脑性瘫痪的风险越小。脑性瘫痪的危险因素还有出生方式、早产、高胆红素血症、肺炎、败血症、缺氧缺血性脑病、窒息、双胎、多胎、出生地点。结论:加强围生期保健,减少早产等13种危险因素将会明显减少脑性瘫痪的发病。

AIM: To explore the risk factors of cerebral palsy(CP),and provide scientifi c evidence for preventing CP effectively. METHODS:A cross sectional survey to 6 countries(cities),taking countrysides(t owns)as a unit,was carried out among 95435 children,aged 1-6,with CP from 41 s ample countrysides(towns).1:2 matched case- control study was conducted to find out the etiological factors of the CP. RESULTS:A total of 171 patients with CP were found out. The prevalence rate o f CP in Hebei was 1.77% .Thirteen significant factors were screened by logistic regression analysis. Educational level of mother,family income,birth weight wer e the protective factors(regression coefficient were negative,they were-0.414 ,-1.667,-0.000657 respectively, P< 0.05-0.01). The better the educational level of mother,family income,birth weight were,the less the CP occurrence was. Other risk factors of CP were birth means,premature delivery,hyperbilirubinemia, pneumonitis,septicaemia,hypoxic ischemic encephalopathy,asphyxiation,twinning or multiple pregnancy,birth place. CONCLUSION:If the heath care of perinatal period is intensified,the 13 kinds of risk factors mentioned above could be avoided,the prevalence rate of CP will decrease.