Alberta婴儿运动量表和头部MRI以及脑干听觉诱发电位在脑瘫高危儿中的联合应用

摘要

目的 探讨Alberta婴儿运动量表(Alberta infant motor scale,AIMS)、头部磁共振成像(magnetic resonance imaging,MRI)和脑干听觉诱发电位(brainstem suditory evoked potential,BAEP)在脑瘫高危儿中的联合应用.方法 2015年6月至2016年6月在本院NICU出院并在儿童神经康复科完成随访的脑瘫高危儿586例,在3个月时用AIMS评估运动发育,行头部MRI和BAEP检查,结合病史和临床检查结果,对发生脑瘫可能性较大的高危儿进行早期干预治疗,其他高危儿定期随访.结果 本次研究最终临床确诊脑瘫患儿114例,脑瘫发生率为19.45％.其中痉挛型四肢瘫21例(18.42％),痉挛型双瘫45例(39.47％),痉挛型偏瘫19例(16.67％),不随意运动型18例(15.79％),共济失调型6例(5.26％),混合型5例(4.39％).脑瘫患儿中AIMS异常率为90.35％,头部MRI异常率为84.21％,BAEP异常率为78.95％.非脑瘫患儿中AIMS异常率为21.23％,头部MRI异常率为15.08％,BAEP异常率为12.84％.将脑瘫的发生率与AIMS、头部MRI和BAEP异常率进行相关性分析,均有显著相关性(P＜0.01),相关系数依次为0.692、0.703、0.676.结论 脑瘫的发生与AIMS、头部MRI和BEAP异常率密切相关,联合三项检查能为临床医生的诊断与治疗提供重要依据.%Objective To study the neurodevelopmental predictive value of Alberta infant movement scale (AIMS),head magnetic resonance imaging (MRI),and brainstem auditory evoked potential (BAEP) for high risk infants with cerebral palsy.Methods From June 2015 to June 2016,586 high-risk infants with cerebral palsy discharged from the NICU of our hospital and followed up by Department of Children's Nerve Rehabilitation were evaluated the motor development by AIMS and took line head MRI and BAEP examinations 3 months after discharge.According to the disease history and examination results,the infants with high risk of cerebral palsy took early intervention treatment and other high-risk infants were followed up regularly.Results Finally,114 infants were diagnosed with cerebral palsy;so the incidence of cerebral palsy was 19.45％.In the children with cerebral palsy,the abnormal rate by AIMS was 90.35％,that by head MRI 84.21％,and that by BAEP 78.95％.In children with cerebral palsy,the abnormal rate by AIMS was 21.23％,that by head MRI 15.08％,and that by BAEP 12.84％.The analysis of the correlation of incidence of cerebral palsy with AIMS,head MRI,and BAEP abnormal rates showed that all had significant correlations (P ＜ 0.01),and the correlation coefficients were 0.692,0.703,and 0.676.Conclusions The occurrence of cerebral palsy closely relates with AIMS,head MRI,and BEAP abnormal rates.The combination of the three can provide some references for the diagnosis and treatment.