全身运动细化评分在早产儿脑损伤早期评估中的作用

吕媛; 任素伟; 林春; 李榕; 李文康; 陈雨天; 侯玮玮

doi:10.7619/jcmp.20220415

全身运动细化评分在早产儿脑损伤早期评估中的作用

1.
扬州大学临床医学院/江苏省苏北人民医院儿科, 江苏扬州, 225000
2.
扬州大学临床医学院/江苏省苏北人民医院康复医学科, 江苏扬州, 225000
3.
大连医科大学, 辽宁大连, 116044

基金项目:

苏北人民医院院扶持技术项目 fcjs2017028

苏北人民医院院扶持技术项目 fcjs2017042

详细信息

通讯作者:
侯玮玮, E-mail: 15062799032@163.com

中图分类号: R722.6;R651
计量
- 文章访问数: 168
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- PDF下载量: 13
出版历程
- 收稿日期: 2022-02-10
- 网络出版日期: 2022-06-21

Role of general movement optimality scores in early assessment of premature infants with brain injury

1.
Pediatric Department, Clinical College of Yangzhou University, Subei People′s Hospital of Jiangsu Province, Yangzhou, Jiangsu, 225000
2.
Rehabilitation Medicine Department, Clinical College of Yangzhou University, Subei People′s Hospital of Jiangsu Province, Yangzhou, Jiangsu, 225000
3.
Dalian Medical University, Dalian, Liaoning, 116044

摘要

摘要:
目的
探讨全身运动细化评分(GMOS)在早产儿脑损伤早期评估中的作用。
方法
回顾性分析完善头颅影像学及行全身运动(GMs)质量整体评估的175例早产儿资料，根据影像学资料将其分为脑损伤组(n=92)和非脑损伤组(n=83)。根据胎龄将上述2组早产儿分为<32周组(n=66)和32~36周组(n=109)。比较2组一般资料、GMs整体评估异常率和GMOS。采用受试者工作特征(ROC)曲线分析GMOS对早产儿脑损伤早期评估的效能。
结果
2组男性占比、剖宫产占比比较，差异有统计学意义(P < 0.05)。2组GMs整体评估结果比较，差异无统计学意义(χ²=0.25, P=0.617)。非脑损伤组GMOS为27.0(25.0, 29.0)分, 高于脑损伤组的24.5(23.0, 27.0)分, 差异有统计学意义(P < 0.001)。在 < 32周组和32~36周组中，非脑损伤早产儿GMOS均高于脑损伤早产儿，差异有统计学意义(P < 0.05)。GMOS早期评估早产儿脑损伤的曲线下面积(AUC)为0.680, 最佳阈值为25.5分，灵敏度为0.675, 特异度为0.652, 约登指数为0.327。
结论
GMOS简便、可行，可作为早产儿脑损伤的一项评估手段。
- 全身运动细化评分 /
- 早产儿 /
- 脑损伤 /
- 早期评估 /
- 神经系统
Abstract:
Objective
To investigate the role of general movement optimality scores (GMOS) in early assessment of premature infants with brain injury.
Methods
Data of 175 premature infants who received cranial imaging and general movements (GMs) general evaluation were retrospectively analyzed, and were divided into brain injury group (n=92) and non-brain injury group (n=83)according to imaging data. According to gestational age, preterm infants were divided into <32 weeks group (n=66) and 32 to 36 weeks group (n=109). Basic conditions of the two groups were compared and difference of GMOS between them were analyzed. General data, GMs global assessment abnormal rate and GMOS score were compared between the two groups. Receiver operating characteristic (ROC) curve was used to analyze the efficacy of GMOS in early assessment of premature brain injury.
Results
There were statistically significant differences in proportion of male and cesarean section proportion between the two groups (P < 0.05). There was no significant difference in GMs assessment between the two groups (χ²=0.25, P=0.617). The GMOS of the non-brain injury group was 27.0 (25.0, 29.0) points, which was significantly higher than 24.5 (23.0, 27.0) points of the brain injury group (P < 0.001). In the <32 weeks group and 32 to 36 weeks group, the GMOS of the premature infants without brain injury was significantly higher than that of the premature infants with brain injury (P < 0.05). The area under the curve (AUC) of GMOS for early assessment of premature brain injury was 0.680, the optimal threshold was 25.5 points, the sensitivity was 0.675, the specificity was 0.652, and the Yoden index was 0.327.
Conclusion
GMOS is simple and feasible, and can be used as an evaluation method for premature brain injury.
- general movement optimality scores /
- premature infant /
- brain injury /
- early evaluation /
- nervous system

HTML全文

图 1 GMOS评估早产儿脑损伤的ROC曲线

下载: 全尺寸图片幻灯片

表 1 2组早产儿一般情况比较(x±s)[n(%)][M(P₂₅, P₇₅)]

组别	胎龄/周	男性	剖宫产	出生体质量/g	小于胎龄儿	孕期并发症/合并症	有窒息复苏史
非脑损伤组(n=83)	32.90±2.40	43(51.81)	24(28.92)	1 830.00(1 550.00, 2 220.00)	10(12.05)	71(85.54)	21(25.30)
脑损伤组(n=92)	32.40±2.70	64(69.56)^*	68(73.91)^*	1 810.00(1 527.00, 2 200.00)	8(8.70)	83(90.22)	25(27.17)
与非脑损伤组比较, * P < 0.05。

下载: 导出CSV

表 2 不同胎龄早产儿GMOS结果比较[M(P₂₅, P₇₅)]

指标	< 32周组(n=66)		32~36周组(n=109)
指标	非脑损伤(n=27)	脑损伤(n=39)	非脑损伤(n=56)	脑损伤(n=53)
全身运动细化评分/分	25.0(24.0, 27.0)	24.0(22.0, 25.0)^*	27.0(26.0, 33.0)	25.0(24.0, 27.0)^*
与非脑损伤比较, * P < 0.05。

下载: 导出CSV

参考文献(11)

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