摘要
目的分析小儿脑性瘫痪(CP)相关高危因素。方法将2018年6月—2019年6月在湖南省儿童医院就诊的163例CP患儿作为研究组,另选择同期门诊体检健康儿童326例为对照组。采用调查问卷收集2组患儿产前、产时和产后情况,对小儿CP产前因素、产时因素和产后因素进行单因素分析,对具有统计学意义的变量进行多因素Logistic回归分析,同时完善CP患儿染色体检测。结果 163例CP患儿共检出染色体多态性变化30例,异染色质检出率为18.40%,其中9号染色体多态性变化最多(10.43%)。孕妇年龄大于35岁、类似疾病家族史、不良孕产史、有害物质接触史、宫内窘迫、多胎妊娠、有合并症是发生小儿CP的产前因素(P <0.05);早产、新生儿窒息、难产是发生小儿CP的产时因素(P <0.05);低出生体质量、缺氧缺血性脑病、新生儿低血糖是发生小儿CP的产后因素(P <0.05);孕妇年龄大于35岁、有CP及类似疾病家族史、多胎妊娠、有合并症、早产、新生儿窒息和低出生体质量为小儿CP独立危险因素(P <0.05)。根据优势比值(OR值)大小,对小儿CP影响从大到小的危险因素依次为有合并症、孕妇年龄大于35岁、早产、低出生体质量、有CP及类似疾病家族史、多胎妊娠、新生儿窒息。结论产前因素是造成小儿CP的主要原因,也是造成产时及某些新生儿时期疾病的重要原因。CP发病与遗传因素有关,临床应加强孕期保健、孕妇健康管理,完善精准基因检测,准确评估CP发病风险,及时进行早期干预以减少小儿CP的发生。
Objective To analyze the related high-risk factors of cerebral palsy(CP)in children.Methods A total of 163 CP children in Hunan Children’s Hospital from June 2018 to June2019 were selected as study group,and 326 healthy children with physical examination in Outpatient Department at the same time were selected as control group.The questionnaire was used to collect the prenatal,intrapartum and postpartum conditions in both groups.The prenatal,intrapartum and postpartum factors of CP were analyzed by single factor analysis.Multivariate Logistic regression analysis was performed on the variables with statistical significance.Meanwhile,chromosomal test of CP children was completed.Results In 163 CP children,30 cases of chromosome polymorphism were detected,the detection rate of heterochromatin was 18.40%,and among which polymorphism in chromosome 9 was the most(10.43%).Pregnancy age over 35 years old,family history of similar diseases,history of adverse pregnancy and childbirth,history of contact with harmful substances,intrauterine distress,multiple pregnancy and complications were the prenatal factors of CP in children(P<0.05),preterm delivery,asphyxia and dystocia were the intrapartum factors of CP(P<0.05),low birth weight,hypoxic-ischemic encephalopathy and hypoglycemia were the postpartum factors of CP in children(P<0.05),and the independent risk factors of CP in children were pregnant age over 35 years old,family history of CP and similar diseases,multiple pregnancy,comorbidity,premature delivery,neonatal asphyxia and low birth weight(P<0.05).According to the Odds Ratio(OR)value,the effect of risk factors for CP in children were comorbidity,pregnant age over 35 years old,premature delivery,low birth weight,family history of CP and similar diseases,multiple pregnancy and neonatal asphyxia in decending order of influence power.Conclusion Prenatal factors are the main causes of CP in children,and are also the important causes of diseases during labor and neonatal period.The incidence of CP is related to genetic factors.In clinical practice,we should strengthen the health care and health management for pregnant women,improve the precise gene detection,accurately assess the risk of CP,and reduce the incidence of CP in children by timely implementation of early intervention.
作者
刘超宇
胡继红
郭春光
周平秋
刘娟
袁丽平
LIU Chaoyu;HU Jihong;GUO Chunguang;ZHOU Pingqiu;LIU Juan;YUAN Liping(Rehabilitation Center,Hunan Children′s Hospital,Changsha,Hunan,410007)
出处
《实用临床医药杂志》
CAS
2020年第22期36-40,共5页
Journal of Clinical Medicine in Practice
基金
湖南省残疾人康复科研项目(2018XK004)。
关键词
脑性瘫痪
遗传因素
产前因素
产时因素
产后因素
cerebral palsy
genetic factors
prenatal factors
intrapartum factors
postpartum factors
