中国儿童保健杂志 ›› 2020, Vol. 28 ›› Issue (12): 1309-1312.DOI: 10.11852/zgetbjzz2020-1073

• 科研论著 • 上一篇    下一篇

Alberta婴儿运动量表在高危儿随访中的应用研究

卞珊珊1, 李海欣1, 王淮燕1,2   

  1. 南京医科大学附属常州市妇幼保健院 1 儿童保健科;2 新生儿科,江苏 常州 214221
  • 收稿日期:2020-06-08 修回日期:2020-07-27 发布日期:2020-12-10 出版日期:2020-12-10
  • 通讯作者: 王淮燕,E-mail:czwhy522@163.com
  • 作者简介:卞珊珊(1990-),女,江苏人,康复治疗师,主要研究方向为儿童早期运动康复。
  • 基金资助:
    江苏省妇幼健康科研资助项目(F201816);南京医科大学科技发展基金面上项目(NMUB2018069);南京医科大学科技发展基金—一般项目(NMUB2018069)

Study of the application of the Alberta Infant Motor Scale in the follow-up of high-risk infants

BIAN Shan-shan1, LI Hai-xin1, WANG Huai-yan1,2   

  1. 1 Department of Child Health, Changzhou Maternal and Child Health Care Hospital, Nanjing Medical University, Changzhou, Jiangsu 214221, China;
    2 Department of Neonatology, Changzhou Maternal and Child Health Care Hospital, Nanjing Medical University, Changzhou, Jiangsu 214221, China
  • Received:2020-06-08 Revised:2020-07-27 Online:2020-12-10 Published:2020-12-10
  • Contact: WANG Huai-yan, E-mail: czwhy522@163.com

摘要: 目的 通过Alberta婴儿运动量表(AIMS)与Gesell发育诊断量表(GDDS)平行效度的研究,以初步探讨AIMS判断高危婴幼儿运动发育异常的百分位参考值。方法 选取2017年1月-2018年2月在常州市妇幼保健院儿童保健高危儿门诊定期体检的268例高危儿为研究对象,均接受AIMS和GDDS评估。AIMS的百分位与GDDS粗大运动发育商(DQ)用于检测平行效度。将所有的高危儿分为足月组和早产组,并将早产组分为3个月龄组。再将GDDS粗大运动DQ<76分别与AIMS百分位<P5,<P10和<P25进行分析,分别计算各组别的Spearman相关系数和Kappa值。结果 在3种标准下,当AIMS判定足月高危儿运动发育异常的百分位取<P10时,与GDDS粗大运动DQ平行效度最好,呈高度一致(Kappa=0.759,P<0.001);对于≤6月龄的早产高危儿组,在任何标准下二者相关性和一致性均差;对于7~12月龄的早产高危儿组,当AIMS判定运动发育异常的百分位取<P25时,二者的相关系数和Kappa值分别为0.779和0.766,呈较好相关和高度一致,而取<P5和<P10时仅呈中度相关和一致;对于>12月龄的早产高危儿组,当AIMS百分位异常取<P10,二者的相关系数和Kappa值最高,均为1,呈高度相关和完全一致。结论 AIMS和北京版GDDS在定量和定性方面为高度一致和相关,对于足月儿和1岁以上早产高危儿可取<P10作为判断运动发育异常的参考值,对于1岁内早产高危儿,AIMS可更敏感地发现运动发育异常,运用其结果判定运动发育异常时仍需综合考虑以决定早期干预时机。

关键词: 高危儿, Alberta婴儿运动量表, Gesell发育诊断量表, 运动发育

Abstract: Objective To analyze the parallel validity of the Alberta Infant Motor Scale(AIMS) and Gesell Development Diagnosis Scale(GDDS), and to primarily set the percentile reference value of AIMS in judging motor developmental abnormalities of high-risk infants. Methods From January 2017 to February 2018, a total of 268 high-risk infants who underwent physical examination in Department of Child Health, Changzhou Maternal and Child Health Care Hospital were enrolled in this study, and were assessed by AIMS and GDDS.The percentile of AIMS and gross movement development quotient(DQ) in GDDS were used to test the parallel validity.All the high-risk infants were divided into full-term group and premature group, and the premature group was then divided into three groups according to month of age.Then the Spearman correlation coefficient and Kappa value of GDDS and AIMS in determining motor developmental abnormalities among each group were calculated. Results When taking P10 as the value for determining motor developmental abnormalities in full-term high-risk infants, the parallel validity with GDDS was the best, showing a high consistency between AIMS and GDDS(Kappa=0.759,P<0.001).For high-risk infants aged 6 months or younger, the correlation and consistency between AIMS and GDDS were poor under any criteria.For preterm high-risk infants aged 7—12 months, when the AIMS percentile was<P25 for the motor developmental abnormalities, the correlation coefficient and Kappa value were 0.779 and 0.766, respectively, showing a good correlation and high consistency.However, it was only moderately correlated and consistent when taking AIMS<P5 and <P10 as the value of the developmental abnormalities.For preterm high-risk infants over 12 months old, when taking AIMS <P10 as the value of the developmental abnormalities, the correlation coefficient and Kappa value were the highest. Conclusions AIMS and Beijing version of GDDS are highly consistent and correlated quantitatively and qualitatively.For full-term high-risk infants and premature high-risk infants over 1 year old, <P10 can be taken as the reference value for judging motor developmental abnormalities.AIMS can more sensitively detect motor developmental abnormalities for premature high-risk infants within 1 year old.When using the percentile of AIMS to determine motor developmental abnormalities, it is still necessary to comprehensively consider for determining the appropriate time of early intervention.

Key words: high-risk infants, Alberta Infant Motor Scale, Gesell Development Diagnosis Scale, motor development

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