Abstract: Objective To establish the early warning score of cerebral palsy in twist-movements infants based on detailed assessment of general movements the study of high-risk infants. Methods The high-risk children who established archives in the department of rehabilitation in Xuzhou Children's Hospital were selected as participants from January 2016 to January 2017.The general movements feature evaluation and refinement score were conducted at corrected age of 4-6 weeks.And 52 neurological exercises were tested for infants at corrected age of 4-8 weeks.At 12 months old (corrected age of 44-52 weeks), different developmental outcomes were determined according to the diagnostic criteria for cerebral palsy.According to the research of health statistics, the early warning score of twist movements detailed assessment was established. Results The detailed assessment scores of twist-movements were significantly different among normal group, poor repertoire group, and synchronous exercise group (F=208.186,P<0.001).It was also positively correlated with 52 items scores(r=0.968, P<0.001).The normal motor development group ("green area") ranged from 27 to 42 points, which was equivalent to more than 27 points.The range of mild abnormalities ("yellow area") ranged from 18 to 26 points.The range of severe abnormalities ("red area") ranged from 5 to 17 points, which was equivalent to 17 points or less.The cerebral palsy warning score of this data showed that the predictive validity was 92.11%, the sensitivity was 100%, the specificity was 90.00%, the positive predictive value was 72.73%, the negative predictive value was 100%, the false positive rate was 10%, and the false negative rate was 0. Conclusion The establishment of warning score on cerebral palsy has higher sensitivity and specificity, lower false positive/negative rates, which can be used by medical personnel in clinical practice.

Key words: detailed assessment of general movements, score, cerebral palsy, screening

摘要： 目的 通过高危儿全身运动细化评估的研究,建立扭动运动阶段的脑性瘫痪预警评分。方法 抽取2016年1月-2017年1月徐州市儿童医院康复科建立档案的高危儿为研究对象。分别在纠正年龄4~6周行全身运动评估及全身运动细化评分,纠正年龄4~8周内测试0~1岁52项神经运动检查,在12月龄(纠正年龄44~52周)时,按照脑瘫诊断标准,确定不同发育结局。按照卫生统计学的研究方法,建立扭动运动阶段全身运动细化评估的脑瘫预警评分。结果 扭动运动阶段的全身运动细化评分,在正常组、单调性运动组和痉挛同步性运动组中差异无统计学意义(F=208.186,P<0.001);与52项运动相关评分呈正相关(r=0.968,P<0.001)。本研究的脑瘫预警评分,运动发育正常组(“绿色区”)的范围为27~42分;轻度异常组(“黄色区”)的范围为18~26分;而重度异常组(“红色区”) 的范围则为5~17分,预测效度为92.11%,敏感度为100%,特异度为90.00%,阳性预测值为72.73%,阴性预测值为100%,假阳性率10%,假阴性率为0。结论 建立的脑瘫预警评分,具有较高的敏感性及特异性,较低的假阳性率及假阴性率,可供同行在临床实践中应用。

关键词: 全身运动细化评估, 评分, 脑瘫, 筛查