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目的分析卵胞浆内单精子注射(ICSI)子代4岁龄智能发育情况。方法选取2009年1月-2009年12月在南京市妇幼保健院进行卵胞浆内单精子注射的单胎活产子代作为研究对象(ICSI,n=18例),以年龄、性别为匹配条件,选取该院出生的自然受孕单胎活产婴儿为作对照组(SC,n=36例);排除标准:孕周<32周,体重<1 500g,有宫内窘迫,出生窒息史者。利用中国韦氏学前儿童智力量表(C-WPPSI)分别比较两组儿童4岁龄的智力发育水平。结果比较两组儿童4岁龄智能发育水平后发现,韦氏智力测验中ICSI子代总智商、言语智商及操作智商均值在正常范围,但得分均低于SC组(总智商:ICSI 100.67±11.45,SC 115.33±10.82;言语智商:97.72±14.21,111.72±12.40;操作智商:104.83±7.87,116.50±10.68),两者差异具有统计学意义(P<0.05)。进一步分析两组智力异常的发生率,发现ICSI子代图画填充项目量表分<7的人数明显高于SC组(ICSI 4/18,SC 0/36,χ2=8.64,P<0.05)。结论有限的样本量结果提示,ICSI子代4岁龄智能发育在正常范围,但韦氏智力测验IQ值低于SC组。ICSI子代远期智能情况需要通过更广泛、长期、系统的随访跟踪才能得出更为详实的结论。
Objective To analyze the intelligence development of 4-year-old offspring in intracytoplasmic sperm injection (ICSI). Methods Single-fetus live-born offspring with intracytoplasmic sperm injection in Nanjing MCH from January 2009 to December 2009 were selected as the study subjects (ICSI, n = 18). The age and gender were matched (SC, n = 36). Exclusion criteria: gestational age <32 weeks, body weight <1500g, with intrauterine distress and history of birth asphyxia. Using the Wechsler preschool children’s intelligence scale (C-WPPSI), the mental development of children aged 4 years were compared. Results After comparing the intelligence development level of 4-year-old children in two groups, we found that the average IQ, verbal IQ and IQ in Wechsler Intelligence Test were in the normal range, but the scores were lower than those in SC group (Total Intelligence: ICSI 100.67 ± 11.45 , SC 115.33 ± 10.82; speech IQ: 97.72 ± 14.21,111.72 ± 12.40; operative intelligence: 104.83 ± 7.87,116.50 ± 10.68), the difference was statistically significant (P <0.05). Further analysis of the incidence of intelligence abnormalities in both groups found that the number of children with ICSI offspring drawing-filled items was significantly higher than that of the SC group (ICSI 4/18, SC 0/36, χ 2 = 8.64, P <0.05). Conclusions The limited sample size suggests that the 4-year-old ICSI progeny develop in the normal range of intelligence, but the Wechsler IQ test is lower than in the SC group. Long-term ICSI offspring intelligence situation needs more extensive, long-term, systematic follow-up tracking can come to more detailed conclusions.