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【目的】研究全身运动质量评估(general movements assessment,GMs)及脑干听觉诱发电位(brainstemauditory evoked potential,BAEP)在脑瘫预测中的运用价值。【方法】按照纳入和排除标准选择在本院新生儿重症监护室住院,出院后在新生儿科和康复中心进行随访的高危新生儿为研究对象。每例记录GMs,并行BAEP检查,根据2005年发布的国际脑瘫诊断定义至少在1周岁以上时在临床上进行脑瘫的诊断,作为严重异常的神经学发育结局。统计分析各方法对脑瘫的阳性预测值和阴性预测值、特异性和敏感性。【结果】共随访27名高危新生儿,其中8例运动结局为脑瘫。GMs预测脑瘫敏感度87.5%,特异度84.2%,阳性预测值70.0%,阴性预测值94.1%;BAEP预测脑瘫敏感度75.0%,特异度36.8%,阳性预测值33.3%,阴性预测值77.7%,BAEP异常主要表现为听阈增高及潜伏期延长。【结论】GMs对后期神经发育结局能作出准确有效的预测,尤其对于脑瘫的预测价值相当高,综合运用GMs、BAEP能较全面反应患儿功能状况。
【Objective】 To investigate the value of general motion assessment (GMs) and brainstem evoked potential (BAEP) in the prediction of cerebral palsy. 【Methods】 According to inclusion and exclusion criteria, we selected high-risk neonates who were hospitalized in our neonatal intensive care unit and were followed up in the neonatology and rehabilitation center after discharge. Each case recorded GMs, parallel BAEP examination, according to the international cerebral palsy diagnostic criteria published in 2005 at least 1 year old or above the clinical diagnosis of cerebral palsy, as a serious abnormal neurological development. Statistical analysis of each method of cerebral palsy positive predictive value and negative predictive value, specificity and sensitivity. 【Results】 A total of 27 high-risk neonates were followed-up, including 8 cases of cerebral palsy. GMs predicted cerebral palsy sensitivity 87.5%, specificity 84.2%, positive predictive value 70.0%, negative predictive value 94.1%; BAEP prediction cerebral palsy sensitivity 75.0%, specificity 36.8%, positive predictive value 33.3%, negative predictive value 77.7% BAEP abnormalities mainly manifested as increased threshold and prolonged latency. 【Conclusion】 GMs can make accurate and effective prognosis for the later neurodevelopmental outcomes, especially for the prediction of cerebral palsy. Using GMs, BAEP can fully reflect the functional status of children.