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Functional outcomes of children with dyskinetic cerebral palsy depend on etiology and gestational age
European Journal of Paediatric Neurology ( IF 2.3 ) Pub Date : 2020-11-01 , DOI: 10.1016/j.ejpn.2020.11.002
Yukihiro Kitai , Satori Hirai , Naomi Okuyama , Mika Hirotsune , Shizuka Nishimoto , Shodo Hirano , Hiroshi Arai

OBJECTIVE To elucidate the differences in etiology of dyskinetic cerebral palsy (DCP) between term-born and preterm-born children and its relationship to functional outcomes. METHODS We determined the etiology of DCP based on the clinical course and brain MRI of 163 term-born and 136 preterm-born children. Information about genetic abnormality was also collected if available. Functional outcomes were compared between the two major etiologies in each group, i.e., hypoxic ischemic encephalopathy (HIE) and bilirubin encephalopathy (BE), using four standardized classification systems, i.e., Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS), and Eating and Drinking Ability Classification System (EDACS). RESULTS The most common etiologies were HIE (123/163) in term-born and BE (93/136) in preterm-born children. Genetic mutations were identified in 14 of 30 term-born children with no other known etiology. GMFCS levels of the preterm children with BE were significantly poorer than those of term children with HIE (p < 0.01). Both the CFCS and EDACS levels were significantly better in preterm children with BE than in term children with HIE (p < 0.01). CONCLUSION The most common etiology of DCP is different between term-born and preterm-born children, and the distribution of functional impairment is significantly influenced by etiology and gestational age. The difference should be taken into consideration to allow the provision of adequate interventions.

中文翻译:

运动障碍性脑瘫儿童的功能结局取决于病因和胎龄

目的 阐明足月和早产儿运动障碍性脑瘫 (DCP) 病因学的差异及其与功能结局的关系。方法 我们根据 163 名足月和 136 名早产儿的临床病程和脑部 MRI 确定 DCP 的病因。如果有的话,还收集了有关遗传异常的信息。使用四种标准化的分类系统,即粗大运动功能分类系统(GMFCS)、手动能力分类系统,比较每组的两种主要病因,即缺氧缺血性脑病(HIE)和胆红素脑病(BE)的功能结果。 MACS)、通信功能分类系统(CFCS)和饮食能力分类系统(EDACS)。结果 最常见的病因是足月出生的 HIE (123/163) 和早产儿的 BE (93/136)。在 30 名没有其他已知病因的足月出生的儿童中,有 14 名被鉴定出基因突变。BE 早产儿的 GMFCS 水平显着低于 HIE 足月儿(p < 0.01)。BE 早产儿的 CFCS 和 EDACS 水平均显着优于 HIE 足月儿(p < 0.01)。结论足月和早产儿DCP最常见的病因不同,功能障碍的分布受病因和胎龄的影响显着。应考虑到差异,以便提供足够的干预措施。在 30 名没有其他已知病因的足月出生的儿童中,有 14 名被鉴定出基因突变。BE 早产儿的 GMFCS 水平显着低于 HIE 足月儿(p < 0.01)。BE 早产儿的 CFCS 和 EDACS 水平均显着优于 HIE 足月儿(p < 0.01)。结论足月和早产儿DCP最常见的病因不同,功能障碍的分布受病因和胎龄的影响显着。应考虑到差异,以便提供足够的干预措施。在 30 名没有其他已知病因的足月出生的儿童中,有 14 名被鉴定出基因突变。BE 早产儿的 GMFCS 水平显着低于 HIE 足月儿(p < 0.01)。BE 早产儿的 CFCS 和 EDACS 水平均显着优于 HIE 足月儿(p < 0.01)。结论足月和早产儿DCP最常见的病因不同,功能障碍的分布受病因和胎龄的影响显着。应考虑到差异,以便提供足够的干预措施。BE 早产儿的 CFCS 和 EDACS 水平均显着优于 HIE 足月儿(p < 0.01)。结论足月和早产儿DCP最常见的病因不同,功能障碍的分布受病因和胎龄的影响显着。应考虑到差异,以便提供足够的干预措施。BE 早产儿的 CFCS 和 EDACS 水平均显着优于 HIE 足月儿(p < 0.01)。结论足月和早产儿DCP最常见的病因不同,功能障碍的分布受病因和胎龄的影响显着。应考虑到差异,以便提供足够的干预措施。
更新日期:2020-11-01
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