早期运动发育指标对早产儿脑性瘫痪的诊断价值

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，782％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29．1％～56.5％，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3项指标适用于脑瘫的早期筛查和早期诊断。

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

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.