小儿脑性瘫痪的病因背景学研究

刘超宇, 胡继红, 郭春光, 周平秋, 刘娟, 袁丽平

刘超宇, 胡继红, 郭春光, 周平秋, 刘娟, 袁丽平. 小儿脑性瘫痪的病因背景学研究[J]. 实用临床医药杂志, 2020, 24(22): 36-40. DOI: 10.7619/jcmp.202022010
引用本文: 刘超宇, 胡继红, 郭春光, 周平秋, 刘娟, 袁丽平. 小儿脑性瘫痪的病因背景学研究[J]. 实用临床医药杂志, 2020, 24(22): 36-40. DOI: 10.7619/jcmp.202022010
LIU Chaoyu, HU Jihong, GUO Chunguang, ZHOU Pingqiu, LIU Juan, YUAN Liping. A study on the etiology background of cerebral palsy in children[J]. Journal of Clinical Medicine in Practice, 2020, 24(22): 36-40. DOI: 10.7619/jcmp.202022010
Citation: LIU Chaoyu, HU Jihong, GUO Chunguang, ZHOU Pingqiu, LIU Juan, YUAN Liping. A study on the etiology background of cerebral palsy in children[J]. Journal of Clinical Medicine in Practice, 2020, 24(22): 36-40. DOI: 10.7619/jcmp.202022010

小儿脑性瘫痪的病因背景学研究

基金项目: 

湖南省残疾人康复科研项目(2018XK004)

详细信息
    通讯作者:

    胡继红, E-mail: 1211584458@qq.com

  • 中图分类号: R742.3;R816.92

A study on the etiology background of cerebral palsy in children

  • 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。
    Abstract: 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 June 2019 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.
  • KOY A, TIMMERMANN L. Deep brain stimulation in cerebral palsy: Challenges and opportunities[J]. Eur J Paediatr Neurol, 2017, 21(1): 118-121.

    黄小玲, 陈景汉, 刘汇团, 等. 333例脑瘫儿童病因高危因素分析[J]. 国际医药卫生导报, 2019, 25(8): 1199-1202.

    PENNINGTON L, LOMBARDO E, STEEN N, et al. Acoustic changes in the speech of children with cerebral palsy following an intensive program of dysarthria therapy[J]. Int J Lang Commun Disord, 2017, 53(1): 182-195.

    朱庆文, 倪玉飞, 王婧, 等. 10例以脑发育不良为主要特征的脑瘫患儿的遗传学病因分析[J]. 中华医学遗传学杂志, 2019, 36(3): 229-233.
    李晓捷. 《脑瘫指南及定义、分型、诊断标准修订》[C] //第六届全国儿童康复、第十三届全国小儿脑瘫康复学术会议暨国际学术交流会议. 2014.

    MELLER C H, IZBIZKY G H, OTAÑO L. Prenatal Factors in Cerebral Palsy[J]. N Engl J Med, 2015, 373(23): 2288-2289.

    龙滨, 陈琳, 尹艳艳. 探析孕妇妊娠晚期B族链球菌感染对妊娠结局及新生儿的影响[J]. 中国实用医药, 2017, 12(35): 70-72.

    LINDSAY K L, BUSS C, WADHWA P D, et al. The Interplay between Maternal Nutrition and Stress during Pregnancy: Issues and Considerations[J]. Ann Nutr Metab, 2017, 70(3): 191-200.

    代立静. 关于妊娠期孕妇营养状况与胎儿发生出生缺陷的相关性探究[J]. 大家健康旬刊, 2017, 11(1): 193-193.

    LUNDGREN C, BRUDIN L, WANBY A S, et al. Ante- and intrapartum risk factors for neonatal hypoxic ischemic encephalopathy[J]. J Matern Fetal Neonatal Med, 2017, 31(12): 1595-1601.

    提鑫婧, 林梦梦, 刘扬, 等. 居住环境因素对出生缺陷影响的Meta分析[J]. 中国儿童保健杂志, 2019, 27(4): 411-413

    , 428.

    赵茹茹, 刘铭, 段涛. 孕激素预防双胎妊娠自发性早产的研究进展[J]. 中华围产医学杂志, 2017, 20(1): 61-64.

    YIN Y, LI C, XU C, et al. Intestinal obstruction due to congenital malrotation complicating a multiple pregnancy: A rare case report[J]. J Pak Med Assoc, 2017, 67(2): 308-310.

    TUPIKOV V A, KOLMAKOVA T S, SHAMIK V B, et al. [Results of a clinical and genealogical analysis of pedigrees of children with cerebral palsy in the population of Rostov region] [J]. Zh Nevrol Psikhiatr Im S S Korsakova, 2017, 117(7): 80-85.

    夏开德, 周晓涛, 杨雪, 等. 贵州地区儿童患者染色体多态性的细胞遗传学分析[J]. 中国优生与遗传杂志, 2018, 26(6): 43-45.
    朱佳鹏, 何慧燕, 梁灼健, 等. 染色体多态性与生殖异常的相关性分析[J]. 中华医学遗传学杂志, 2018, 35(6): 921-922.

    LERER I, SAGI M, MEINER V, et al. Deletion of the ANKRD15 gene at 9p24.3 causes parent-of-origin-dependent inheritance of familial cerebral palsy[J]. Hum Mol Genet, 2005, 14(24): 3911-3920.

    PASHMDARFARD M, AMINI M, HASSANI M A. Participation of Iranian Cerebral Palsy Children in Life Areas: A Systematic Review Article[J]. Iran J Child Neurol, 2017, 11(1): 1-12.

    PAULSEN M E, DIETZ R M. Antenatal magnesium for preterm delivery reduces risk of cerebral palsy among surviving very preterm infants[J]. Acta Paediatr, 2018, 107(1): 175.

  • 期刊类型引用(4)

    1. 崔庆凤,杨李,郑世柱. 引导式教育在提高脑性瘫痪患儿粗大运动和认知功能的疗效分析. 河北医科大学学报. 2022(03): 307-310 . 百度学术
    2. 刘玉玲,黄蓉. 多部位联合生物刺激反馈治疗结合神经发育疗法对脑性瘫痪患儿智力水平、交流功能及运动功能的影响. 中国医学工程. 2022(04): 112-116 . 百度学术
    3. 马卫平. 小儿脑性瘫痪患儿检查视频脑电图、脑干听觉诱发电位、视觉诱发电位对早期诊断的应用价值. 数理医药学杂志. 2021(10): 1557-1559 . 百度学术
    4. 陈可可,洪轶男. 本体感觉神经肌肉促进技术联合引导式教育对脑性瘫痪患儿运动功能及痉挛状态的影响. 实用医院临床杂志. 2021(06): 139-141 . 百度学术

    其他类型引用(1)

计量
  • 文章访问数:  398
  • HTML全文浏览量:  124
  • PDF下载量:  14
  • 被引次数: 5
出版历程
  • 收稿日期:  2020-07-25
  • 网络出版日期:  2020-12-21
  • 发布日期:  2020-12-02

目录

    /

    返回文章
    返回
    x 关闭 永久关闭