全身运动质量评估预测不同孕周早产高危儿神经发育结局的效度比较

发布时间：2019-04-16 16:13

【摘要】：目的比较全身运动(GMs)质量评估对不同孕周分组的早产高危儿神经发育结局的预测效度。方法按照妊娠28~31+6周、32~33+6周、34~36+6周将180例研究对象分为A、B、C三组,分别进行扭动运动阶段GMs和不安运动阶段GMs评估。通过临床诊断方法和Gesell发育量表,评估随访对象12月龄的运动发育结局,比较GMs评估在不同孕周分组中的预测效度。结果运动发育结局有133例发育正常,47例发育迟缓,其中10例脑瘫。对于运动发育异常的预测效度,扭动运动阶段GMs敏感性40.4%、特异性90.2%、阳性预测值59.4%和阴性预测值81.1%;不安运动阶段GMs敏感性27.7%、特异性99.2%、阳性预测值92.9%和阴性预测值79.5%。不同孕周分组间的GMs评估检出率无显著性差异(P=0.610,P=0.765,P=0.290)。结论 GMs评估特异性和阳性预测值中,不安运动缺乏的评估最高;其次是痉挛-同步性。GMs评估中不安运动缺乏及痉挛-同步性更能够准确区分运动发育结局有无异常。GMs评估对28~36+6周的早产儿神经运动发育异常检出率无显著性差异。
[Abstract]:Objective to compare the predictive validity of whole body exercise (GMs) quality assessment for neurodevelopmental outcomes in preterm high-risk preterm infants in different gestational weeks. Methods according to 28? 31.6 weeks, 32? 33.6 and 34? 366 weeks of pregnancy, 180 cases were divided into three groups: group A, group B, and group C, which were evaluated by GMs and GMs at the stage of kink and restlessness, respectively. The patients were divided into three groups: group A, group B, and group C. The outcome of 12-month-old motor development was evaluated by clinical diagnosis and Gesell development scale, and the predictive validity of GMs assessment in different gestational weeks was compared. Results the outcome of motor development was normal in 133 cases, stunted in 47 cases, and cerebral palsy in 10 cases. The sensitivity, specificity, positive predictive value and negative predictive value of GMs were 40.4%, 90.2%, 59.4% and 81.1%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of GMs in restless exercise stage were 27.7%, 99.2%, 92.9% and 79.5% respectively. There was no significant difference in the detection rate of GMs among the groups of different gestational weeks (P = 0.610, P = 0.765, P = 0.290). Conclusion in the evaluation of specificity and positive predictive value of GMs, the lack of restless movement is the highest. The second was spasticity-synchrony. Nervous dyskinesia and spasticity-synchronism were more accurate in the assessment of GMs. There was no significant difference in the detection rate of neurokinesia in preterm infants with 28-36-6 weeks in GMs assessment.
【作者单位】：广西基因组与个体化医学研究重点实验室广西医科大学;广西壮族自治区妇幼保健院;
【基金】：广西医疗卫生重点科研课题(No.重2011062)
【分类号】：R714.21

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