儿童脑性瘫痪的早期筛查研究

Early screening of cerebral palsy during infancy using 'Infant Motor Malfunction Profile' in the communities of two cities

目的 运用“婴儿异常运动功能评定表”在城市社区早期筛查儿童脑性瘫痪的有效性评价。方法 在安徽省两座城市通过社区妇幼保健专业人员对8137名婴儿,分别于3、6、9、12月龄时运用“婴儿异常运动功能评定表”中的运动里程碑评价作为筛查第一步,有1项运动里程碑发育异常者运用该筛查表的原始反射和姿势反应检查,作为筛查的第二步,其中有1项异常者由临床医生进行脑瘫诊断。结果 在一般人群中对4个年龄组婴儿分两步筛查,其灵敏度为94.1％,特异度为99.8％,阳性预测值为48.5％,阳性似然比为449.3。结论 运用“婴儿异常运动功能评定表”,通过分步筛查策略,可有效地在婴儿期筛查脑性瘫痪患儿,为早期诊断和早期康复赢得时间。

Objective To evaluate the prospective validity and predictive value of cerebral palsy during infancy, using 'Infant Motor Malfunction Profile'. Methods Items of motor milestone in the profile was used as the first step to screen cerebral palsy on 8137 infants who were screened at 3, 6, 9, 12 months of age. The positive cases who had one of 7 developmental abnormal motor milestone items were examined using the items of primitive reflexes or postural reaction as the secondary step of cerebral palsy screening. The cases who had at least one abnormal item of primitive reflex or postural reaction received neurological examination by doctors to diagnose cerebral palsy. Results According to our data, sensitivity, specificity, positive prospetive value, positive and negative likelihood ratio of the profile in screening cerebral during infancy were 94. 1%, 99. 8%, 48. 5%, 449. 6 and 0. 06, respectively. Conclusion The profile seemed to be an acceptable instrument for early identification of cerebral palsy.