两种评估方法对高危儿粗大运动发育结局和脑性瘫痪预测效度的比较

doi:10.11852/zgetbjzz2015-23-08-23

中国儿童保健杂志 ›› 2015, Vol. 23 ›› Issue (8): 856-858.DOI: 10.11852/zgetbjzz2015-23-08-23

两种评估方法对高危儿粗大运动发育结局和脑性瘫痪预测效度的比较

钟晨¹,杨红²,王文香¹,周立峰³,张晓丽¹

1 杭州市萧山区湘湖康复医院,浙江杭州 311203;
2 复旦大学附属儿科医院上海 200032;
3 杭州市萧山区城厢街道卫生服务中心,浙江杭州 311201

收稿日期:2015-02-11 发布日期:2015-08-10 出版日期:2015-08-10
通讯作者: 杨红,E-mail:hyang@shmu.edu.cn
作者简介:钟晨(1985-),男,浙江人,住院医师,本科学历,主要研究方向为康复医学。

Comparison of predictive validity of two assessment methods for gross motor outcome and cerebral palsy in high risk infants.

ZHONG Chen¹,YANG Hong²,WANG Wen-xiang¹,ZHOU Li-feng³,ZHANG Xiao-li¹.

(1 Xianghu Rehabilitation Hospital of Xiaoshan District,Hangzhou,Zhejiang 311203,China; 2 Children's Hospital,Fudan University,Shanghai 200032,China; 3 Chengxiang Community Health Service Center of Xiaoshan,District,Hangzhou,Zhejiang 311201,China)
Corresponding author:YANG Hong,E-mail:hyang@shmu.edu.cn

Received:2015-02-11 Online:2015-08-10 Published:2015-08-10
Contact: YANG Hong,E-mail:hyang@shmu.edu.cn

摘要/Abstract

摘要： 目的研究全身运动(general movements assessment,GMs)质量评估和0~1岁20项神经运动检查法(20项检查法)对高危儿粗大运动发育结局和脑性瘫痪预测效度的比较。方法按照纳入标准,选择30名高危儿为研究对象,在不安运动阶段(足月后9周龄~5月龄)进行GMs评估以及20项检查法各1次。随访至纠正年龄1周岁以后根据临床表现以及采用Peabody运动发育量表2(Peabody Developmental Motor Scale 2,PDMS-2)评估粗大运动发育结局以及是否为脑性瘫痪。计算两种方法的敏感度、特异度、阳性预测值、阴性预测值以及Kappa值进行比较。结果纳入的30例研究对象中,脑性瘫痪3例(10%)例,粗大运动发育落后5例(16.7%)(包括3例脑性瘫痪),25例(83.3%)正常。GMs对粗大运动发育落后的预测效度:敏感度80.0%,特异度96.0%,阳性预测值80.0%,阴性预测值96.0%;20项检查法对粗大运动发育落后的预测效度:敏感度100.0%,特异度92.0%,阳性预测值71.4%,阴性预测值100.0%。GMs对脑性瘫痪的预测效度:敏感度100.0%,特异度92.6%,阳性预测值60.0%,阴性预测值100.0%;20项检查法对脑性瘫痪的预测效度:敏感度100.0%,特异度85.2%,阳性预测值42.9%,阴性预测值100.0%。两种方法的Kappa值=0.59。结论在足月后9周龄~5月龄阶段,两种方法对粗大运动发育结局的预测各有优势,GMs对脑瘫预测更优,两种评估方法有中等程度的一致性。

关键词: 高危儿, 脑性瘫痪, 全身运动质量评估, 0~1岁20项神经运动检查法, 预测效度
中图分类号:R722 文献标识码:A 文章编号:1008-6579(2015)08-0856-04 doi:10.11852/zgetbjzz2015-23-08-23

Abstract: Objective To compare qualitative general movements assessment (GMs assessment) and 20 items neurological assessment from birth to 1 year (20 items assessment) for gross motor outcome and cerebral palsy in high risk infants.Methods According to the inclusion criteria,30 infants were confirmed as the participants.GMs and 20 items were assessed one times during fidgety movements period (correct age from 9 weeks to 5 months).Gross motor outcome and cerebral palsy were determined by clinic performs and Peabody Developmental Motor Scale at least after one year old.Sensitivity,specificity,positive predictive value,negative predictive value and Kappa index were calculated.Results 3（10%） infants were cerebral palsy,5 (16.7%) infants were gross motor retardation,25(83.3%) infants were normal gross motor development.Predictive validity of GMs for gross motor retardation was as follows：sensitivity 80.0%,specificity 96.0%,positive predictive value 80.0%,negative predictive value 96.0%；Predictive validity of 20 Items for gross motor retardation was as follows：sensitivity 100.0%,specificity 92.6%,positive predictive value 60.0%,negative predictive value 100.0%；Predictive validity of GMs for cerebral palsy was as follows：sensitivity 100.0%,specificity 92.6%,positive predictive value 60.0%,negative predictive value 100.0%；Predictive validity of 20 Items for cerebral palsy was as follows：sensitivity 100.0%,specificity 85.2%,positive predictive value 42.9%,negative predictive value 100.0%；Kappa=0.59.Conclusions During fidgety movements period，predictive validity for gross motor retardation of two methods have advantages,GMs is better at predicting cerebral palsy.Two methods with moderate consistency,have comprehensive application in high risk infants follow-up work.

Key words: high risk infant, cerebral palsy, qualitative general movements assessment, 20 items neurological assessment from birth to 1 year, predictive validity

中图分类号:

R722

钟晨,杨红,王文香,周立峰,张晓丽. 两种评估方法对高危儿粗大运动发育结局和脑性瘫痪预测效度的比较[J]. 中国儿童保健杂志, 2015, 23(8): 856-858.

ZHONG Chen,YANG Hong,WANG Wen-xiang,ZHOU Li-feng,ZHANG Xiao-li.. Comparison of predictive validity of two assessment methods for gross motor outcome and cerebral palsy in high risk infants.[J]. journal1, 2015, 23(8): 856-858.

[1]	王曼, 肖莹莹, 张园园, 张立新. 数字OT系统辅助下分析全身振动训练对脑瘫患儿精细运动能力影响的临床研究[J]. 中国儿童保健杂志, 2023, 31(5): 491-496.
[2]	王慧, 王丽娟, 童连, 汪军, 张雅萍, 张卿. 母亲生育年龄及喂养行为与高危儿早期运动发育的相关分析[J]. 中国儿童保健杂志, 2023, 31(4): 422-426.
[3]	沈修姝, 汪军. 全身运动评估的临床应用研究进展[J]. 中国儿童保健杂志, 2023, 31(2): 167-170.
[4]	范桃林, 刘杰, 贺晨, 谭玲惠, 李游, 肖喜辉, 姜灿. 基于镜像神经元的动作观察训练对脑瘫儿童平衡和步行能力的影响[J]. 中国儿童保健杂志, 2023, 31(2): 220-224.
[5]	施磊, 童光磊, 李红, 陈婧, 吴杉杉. 脑性瘫痪儿童喂养/吞咽困难和营养不良筛查工具的临床应用[J]. 中国儿童保健杂志, 2022, 30(9): 1024-1028.
[6]	赵明月, 项栋良, 张春艳, 乌云塔娜, 杨海凤, 李爽, 王琰, 王艳. 高危儿早期干预的研究进展[J]. 中国儿童保健杂志, 2022, 30(5): 531-534.
[7]	宋福祥, 孔祥颖, 郭津, 林萍, 张朋, 李鑫. 痉挛型脑瘫患儿用腹肌训练器的研制与应用研究[J]. 中国儿童保健杂志, 2022, 30(3): 339-342.
[8]	胡燕. 高危儿营养支持热点问题思考[J]. 中国儿童保健杂志, 2022, 30(2): 117-119.
[9]	刘喜红. 高危儿的营养支持与健康管理[J]. 中国儿童保健杂志, 2022, 30(2): 120-123.
[10]	梁伟健, 葛胜男, 万勤, 陈芳芳. 连续语音下学龄期脑瘫的流利性特征及其与言语可懂度的相关性[J]. 中国儿童保健杂志, 2022, 30(11): 1173-1176.
[11]	牛国辉, 谢加阳, 朱登纳, 王军, 刘红星, 王鑫, 李停停. 脑性瘫痪患儿共患癫痫的危险因素[J]. 中国儿童保健杂志, 2022, 30(11): 1241-1245.
[12]	郝朝丽, 吴茜茜, 韩清梅, 曾佩, 郭津. 目标-活动-运动强化疗法对脑瘫高危儿早期干预的应用进展[J]. 中国儿童保健杂志, 2022, 30(10): 1104-1107.
[13]	华祎, 王益, 汪莹莹, 黄倩, 沈惠娟, 陈华琴, 陈语, 李红新. B类高危儿293例信息化管理随访分析[J]. 中国儿童保健杂志, 2022, 30(1): 102-105.
[14]	韩佳乐, 王景刚, 曹建国. 高危儿早期神经学评估方法[J]. 中国儿童保健杂志, 2021, 29(9): 981-985.
[15]	中国医师协会儿科医师分会儿童保健学组. NICU出院高危儿0～3岁生长发育随访管理技术的专家共识[J]. 中国儿童保健杂志, 2021, 29(8): 809-814.

两种评估方法对高危儿粗大运动发育结局和脑性瘫痪预测效度的比较

Comparison of predictive validity of two assessment methods for gross motor outcome and cerebral palsy in high risk infants.

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics