HINE联合Gesell对脑瘫高危儿早期识别的应用价值

周燕; 蔡荷飞; 汤行录

doi:10.16766/j.cnki.issn.1674-4152.003206

HINE联合Gesell对脑瘫高危儿早期识别的应用价值

doi: 10.16766/j.cnki.issn.1674-4152.003206

周燕¹,
蔡荷飞²,
汤行录^{1, 3, ,}

1.
温州医科大学附属台州妇女儿童医院儿童康复科, 浙江台州 318001
2.
台州市中心医院(台州学院附属医院)儿内科, 浙江台州 318001
3.
温州医科大学附属第二医院儿童康复科, 浙江温州 325088

基金项目:

浙江省医药卫生科技计划项目 2020KY640

详细信息

通讯作者:
汤行录，E-mail：docroad@sina.com

中图分类号: R729 R742.3
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- 文章访问数: 157
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- 被引次数: 0
出版历程
- 收稿日期: 2023-02-06
- 网络出版日期: 2023-11-23

Application value of HINE combined with skull Gesell in early recognition of high risk infants with cerebral palsy

ZHOU Yan¹,
CAI Hefei²,
TANG Xinglu^{1, 3
, ,}

1.
Department of Children's Rehabilitation, Taizhou Women's and Children's Hospital, Taizhou, Zhejiang 318001, China

摘要

摘要: 目的将Hammersmith婴儿神经学检查量表(HINE)和Gesell发育量表联合应用于脑瘫高危儿的早期筛查，旨在开发出更完善更高效的早期筛查方案。方法选择台州市妇女儿童医院及台州市中心医院于2020年10月—2021年12月就诊的脑瘫高危儿80例为脑瘫高危组；另选择同期健康婴幼儿50例为对照组。比较脑瘫高危儿和健康婴幼儿HINE量表和Gesell发育量表评分；分析HINE联合Gesell发育量表对脑瘫高危儿早期识别价值。结果脑瘫高危组颅神经[(12.94±1.81)分]、运动[(4.59±1.04)分]、姿势[(15.91±1.86)分]、反射和反应[(12.91±1.94)分]、肌张力[(21.38±2.73)分]及量表总分[(67.71±8.61)分]均低于对照组[(13.62±1.11)分、(5.32±0.62)分、(16.78±1.25)分、(13.96±1.12)分、(23.30±0.88)分、(72.98±3.36)分，均P < 0.05]。脑瘫高危组应物、精细动作、粗大运动和应人DQ值低于对照组(均P < 0.05)，而脑瘫高危组语言DQ值比较差异无统计学意义(P＞0.05)。经ROC曲线分析，HINE联合Gesell量表对脑瘫高危儿早期预测灵敏度(96.3%)和特异度(96.0%)高于HINE量表(86.3%、70.0%)与Gesell量表(87.5%、58.0%，P < 0.05)。结论 HINE量表联合Gesell发育量表对脑瘫高危儿早期识别价值显著，灵敏度和特异度良好。
- Hammersmith婴儿神经学检查量表 /
- Gesell发育量表 /
- 脑瘫高危儿 /
- 早期识别
Abstract: Objective The combined application of the Hammersmith infant neurological examination scale (HINE) and the Gesell developmental scale in early screening of high-risk infants with cerebral palsy aims to develop a more comprehensive and efficient early screening plan. Methods Select Taizhou Women's and Children's Hospital and Taizhou Central Hospital to study 80 high-risk children with cerebral palsy from October 2020 to December 2021; another 50 healthy infants and young children in the same period were selected as the control group. To compare the scores of the HINE scale and the Gesell developmental scale scores between high-risk infants with cerebral palsy and healthy infants; to analyze the early recognition value of HINE combined with Gesell developmental scale in high-risk infants with cerebral palsy. Results The high-risk cerebral palsy group had lower scores in cranial nerves [(12.94±1.81) points], motor [(4.59±1.04) points], posture [(15.91±1.86) points], reflexes and reactions [(12.91±1.94) points], muscle tone [(21.38±2.73) points] and total scale score [(67.71±8.61) points] compared to the control group [(13.62±1.11) points, (5.32±0.62) points, (16.78±1.25) points, (13.96±1.12) points, (23.30±0.88) points, and (72.98±3.36) points], the differences were statistically significant (all P < 0.05). The DQ scores of reaction, fine motor, gross motor, and response were lower in the high-risk cerebral palsy group than control group (all P < 0.05); while the DQ values of language in the high-risk cerebral palsy group had no statistical significance (P>0.05). By receiver operating characteristic analysis, the sensitivity (96.3%) and specificity (96.0%) of HINE combined with Gesell scale for early prediction of high risk infants with cerebral palsy were higher than those of HINE scale (86.3%, 70.0%), Gesell scale (87.5%, 58.0%, P < 0.05). Conclusion HINE combined with the Gesell Scales of Brain Development is of great value in the early recognition of high-risk infants with cerebral palsy and can improve the diagnostic sensitivity and specificity.
- Hammersmith infant neurological examination scale /
- Gesell development scale /
- High-risk infants with cerebral palsy /
- Early recognition

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图 1 HINE联合Gesell量表对脑瘫高危儿早期识别价值的ROC曲线

Figure 1. ROC curve for the early identification value of the HINE combined with the Gesell scale in high-risk infants with cerebral palsy

下载: 全尺寸图片幻灯片

表 1 2组婴幼儿HINE量表评分比较(x ±s，分)

Table 1. Comparison of HINE scale scores between two groups of infants (x ±s, points)

组别	例数	颅神经	运动	姿势	反射和反应	肌张力	量表总分
脑瘫高危组	80	12.94±1.81	4.59±1.04	15.91±1.86	12.91±1.94	21.38±2.73	67.71±8.61
对照组	50	13.62±1.11	5.32±0.62	16.78±1.25	13.96±1.12	23.30±0.88	72.98±3.36
t值		2.655	5.013	2.889	3.878	5.820	4.906
P值		0.009	＜0.001	0.005	＜0.001	＜0.001	＜0.001

下载: 导出CSV

表 2 2组婴幼儿Gesell量表检查结果比较(x ±s)

Table 2. Comparison of Gesell scale results between two groups of infants (x ±s)

组别	例数	应物	语言	精细动作	粗大运动	应人
脑瘫高危组	80	81.97±12.51	90.03±6.36	84.46±11.32	84.27±9.32	86.14±7.84
对照组	50	88.64±5.31	91.40±5.40	89.12±4.65	89.47±6.59	90.10±5.46
t值		4.201	1.265	3.268	3.435	3.119
P值		＜0.001	0.208	0.001	0.001	0.002

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表 3 HINE联合Gesell量表对脑瘫高危儿的早期识别价值分析

Table 3. Analysis of early identification value of HINE combined with Gesell scale for high-risk infants with cerebral palsy

项目	曲线下面积	灵敏度(%)	特异度(%)	95% CI
HINE量表	0.777	86.3	70.0	0.679~0.875
Gesell量表	0.716	87.5	58.0	0.612~0.820
HINE联合Gesell量表	0.931	96.3	96.0	0.891~0.970

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