| 汤行录,黄宇敏,赵凯怡,等.婴儿运动表现测试对不安运动缺乏高危儿神经发育结局预测价值的研究[J].中华物理医学与康复杂志,2026,48(7):618-623 |
| 婴儿运动表现测试对不安运动缺乏高危儿神经发育结局预测价值的研究 |
|
| |
| DOI：10.3760/cma.j.cn421666-20250605-00462 |
| 中文关键词: 高危儿 不安运动缺乏 全身运动质量评估 婴儿运动表现测试 神经发育 |
| 英文关键词: High-risk infants Absence of fidgety movements General movements Test of infant motor performance Neurodevelopment |
| 基金项目:浙江省医药卫生科技计划项目（2020KY640）;浙江省基础公益研究计划（LGF20H170006） |
| 作者 | 单位 | | 汤行录 | 温州医科大学附属第二医院儿童康复科,温州 325000 | | 黄宇敏 | 台州市妇女儿童医院,台州 318000 | | 赵凯怡 | 温州医科大学附属第二医院儿童康复科,温州 325000 | | 周燕 | 台州市妇女儿童医院,台州 318000 | | 何盈波 | 台州市妇女儿童医院,台州 318000 | | 庞琼怡 | 温州医科大学附属第二医院儿童康复科,温州 325000 | | 丁志勇 | 温州医科大学附属第二医院儿童康复科,温州 325000 | | 郑新灵 | 台州市妇女儿童医院,台州 318000 | | 王晓霞 | 台州市妇女儿童医院,台州 318000 | | 黄婷婷 | 温州医科大学附属第二医院儿童康复科,温州 325000 |
|
| 摘要点击次数: 296 |
| 全文下载次数: 208 |
| 中文摘要: |
| 目的 基于婴儿运动表现测试（TIMP）探索不安运动缺乏（F－）高危儿是否存在早期运动发育迟缓，并分析TIMP评分与高危儿在18月龄或以上时间段神经发育结局的相关性。 方法 于2020年3月至2024年12月在温州医科大学附属第二医院台州院区儿童康复科门诊随访的高危儿中，选取了不安运动阶段全身运动（GMs）评估为F－，同时进行了TIMP评分的21例9～17周高危儿为研究对象。收集21例F－高危儿TIMP评分的Z值，并与2～4月龄中国正常婴儿常模对照组TIMP评分的Z值进行对比；然后，根据21例F－高危儿在18月龄或以上的随访结果，将患儿分为神经发育良好组和神经发育不良组，并探讨神经发育结局与TIMP Z值（分为Z≥-1.0和Z<-1.0）是否相关。 结果 21例F－高危儿TIMP评分Z值为-1.26±1.31，F－高危儿组Z值显著低于常模对照组。21例F－高危儿中，共有7例神经发育不良，其中5例脑性瘫痪，2例发育迟缓。在Z≥-1.0的10例F－高危儿中，9例发育良好，1例脑性瘫痪；在Z<-1.0的11例F－高危儿中，5例发育良好，6例发育不良（4例脑性瘫痪，2例发育迟缓）。TIMP测试结果与患儿神经发育结局具有中等一致性（Kappa=0.438，0.4≤Kappa＜0.75），Z≥-1.0组的神经发育结局良好率显著优于Z<-1.0组（Fisher精确检验P=0.043，优势比OR=10.08, 95%CI：1.00～117.00），TIMP测试（以Z=-1.0为界）对神经发育结局阴性预测值达到90%。 结论 F－高危儿存在早期运动发育迟缓。TIMP测评可对F－高危儿进行有效风险分层：Z值≥-1.0者神经发育预后良好率较高（阴性预测值90%），而Z值<-1.0者不良结局风险显著增高。TIMP可作为指导F－高危儿早期干预决策的客观依据。 |
| 英文摘要: |
| Objective To evaluate the Test of Infant Motor Performance (TIMP) as a predictor of neurodevelopmental outcomes at 18 months of age or older for high-risk infants not displaying fidgety movements (F－). Methods Twenty-one high-risk infants identified as F－ using the General Movements Assessment (GMA) were compared with a sample of normal Chinese infants aged 2-4 months using TIMP Z-scores. Based on neurodevelopmental outcomes at ≥18 months, the infants were stratified into favorable and unfavorable outcome groups. The association between outcomes and TIMP Z-scores (stratified by a cutoff at Z=-1.0) was analyzed. Results The mean TIMP Z-score of the F－ high-risk infants was -1.26±1.31, which was significantly lower than the normal control group′s average (t=-4.42, P≤0.001). Among the 21 F－ infants, 7 (33.3%) exhibited adverse neurodevelopmental outcomes, including 5 cases of cerebral palsy and 2 cases of developmental delay. Moreover, the stratification by TIMP Z-scores revealed a marked disparity in outcomes: 9 of the 10 cases in the Z≥-1.0 group developed well, while only 5 of the 11 cases (45.5%) in the Z<-1.0 group had favorable outcomes (4 with cerebral palsy and 2 with developmental delay). So the TIMP test results demonstrated moderate agreement with neurodevelopmental outcomes (Kappa = 0.438). Meanwhile, the favorable outcome rate was significantly higher in the Z≥-1.0 group compared to the Z<-1.0 group (Fisher′s exact test P=0.043; odds ratio = 10.08, 95% CI ［1.00-117.00］). Using a cutoff of Z=-1.0, the TIMP yielded a negative predictive value of 90% for adverse neurodevelopmental outcomes. Conclusion High-risk infants with F- exhibit early motor development delays. The TIMP assessment effectively stratifies risk in this population: infants with a Z-score -1.0 are at significantly increased risk of adverse outcomes. The TIMP can serve as a valuable objective tool for guiding early intervention decisions for infants with F－. |
|
查看全文
下载PDF阅读器 HTML全文 |
| 关闭 |
|
|
|