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[智力发育迟缓及相关脑瘫对骨骼成熟的影响]

[Repercussion of mental retardation and associated cerebral palsy on skeletal maturation].

作者信息

Sánchez-Lastres J M, Eirís-Puñal J, Otero-Cepeda J L, Pavón-Belinchón P, Castro-Gago M

机构信息

Dpto. de Pediatría. Servicio de Neuropediatría; Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, 15705, España.

出版信息

Rev Neurol. 2002;34(3):236-43.

Abstract

INTRODUCTION

Mental retardation (MR) constitutes a clinical and social relevant condition accounting for 3% of the pediatric population. Studies focusing the repercussion of MR on nutritional status are scarce and, in occasions, have produced contradictory results.

OBJECTIVE

To evaluate the nutritional status of mentally retarded children in our Region, on the basis of skeletal maturation.

PATIENTS AND METHODS

Our sample comprise 128 mentally retarded children (81 boys and 47 girls) aged 0 17 years. In all children a nutritional and social family environment questionnaires and a valuation of a series of nutritional and anthropometric variables were performed. Additionally, bone age was assessed by means of left hand wrist radiograph in a subset of 53 children. A factorial analysis was carried out by means of the statistical package SPSS allowing the obtaining of 2 anthropometric factors and 3 biochemical factors that condensed the most information content. Results of the bone maturation were correlated with age, sex, presence of cerebral palsy (CP), severity of mental retardation, results of nutritional and sociofamilial questionnaire, antiepileptic treatment and nutritional status (anthropometric and biochemical factors).

RESULTS

Although a good correlation exists between bone age and chronological age, 50% of mentally retarded children presented delay in their skeletal maturation. The bone maturation was higher in the boys than in the girls. The presence of CP induced an increase of 12% in the delay of the skeletal maturation. The severity of MR induced differences in the bone age. Both quality of diet and score of anthropometric factor I inversely correlated with bone maturation delay. Parent s age and geographical precedence but not antiepileptic therapy affected the bone maturation.

CONCLUSIONS

Delay in the bone maturation occurs with high prevalence among mentally retarded children. The presence of CP, severity of MR, quality of the diet and sociofamilial and nutritional factors influenced in an outstanding way in the bone maturation.

摘要

引言

智力迟钝(MR)是一种临床和社会相关病症,占儿童人口的3%。关注MR对营养状况影响的研究很少,而且有时会得出相互矛盾的结果。

目的

基于骨骼成熟度评估我们地区智力迟钝儿童的营养状况。

患者和方法

我们的样本包括128名年龄在0至17岁的智力迟钝儿童(81名男孩和47名女孩)。对所有儿童进行了营养和社会家庭环境问卷调查,并对一系列营养和人体测量变量进行了评估。此外,对53名儿童的子集通过左手腕X光片评估骨龄。使用统计软件包SPSS进行因子分析,从而获得2个人体测量因子和3个生化因子,这些因子浓缩了最多的信息内容。骨成熟度的结果与年龄、性别、脑瘫(CP)的存在、智力迟钝的严重程度、营养和社会家庭问卷调查的结果、抗癫痫治疗以及营养状况(人体测量和生化因子)相关。

结果

尽管骨龄与实际年龄之间存在良好的相关性,但50%的智力迟钝儿童骨骼成熟延迟。男孩的骨成熟度高于女孩。CP的存在使骨骼成熟延迟增加了12%。MR的严重程度导致骨龄存在差异。饮食质量和人体测量因子I的得分均与骨成熟延迟呈负相关。父母年龄和地理区域而非抗癫痫治疗影响骨成熟度。

结论

智力迟钝儿童中骨骼成熟延迟的发生率很高。CP的存在、MR的严重程度、饮食质量以及社会家庭和营养因素对骨成熟度有显著影响。

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