白质损伤与早产儿的凝视障碍有关。
White-matter injury is associated with impaired gaze in premature infants.
作者信息
Glass Hannah C, Fujimoto Shinji, Ceppi-Cozzio Camilla, Bartha Agnes I, Vigneron Daniel B, Barkovich A James, Glidden David V, Ferriero Donna M, Miller Steven P
机构信息
Department of Neurology, University of California at San Francisco, San Francisco, California, USA.
出版信息
Pediatr Neurol. 2008 Jan;38(1):10-5. doi: 10.1016/j.pediatrneurol.2007.08.019.
Periventricular leukomalacia is a risk factor for visual impairment in children born prematurely. The impact of diffuse white-matter injury, as detected on magnetic resonance imaging, on early visual function is unknown. We developed two 5-point visual-gaze scores to analyze the association between this clinical assessment and white-matter injury in 93 premature neonates <34 weeks of gestational age at birth. Older postmenstrual age was associated with higher values of the two gaze scores. Infants with moderate or severe white-matter injury had lower scores than their peers without white-matter injury (0.41 points, 95% confidence interval of 0.13-0.69 for visual fixation score; and 0.70 points, 95% confidence interval of 0.30-1.10 for conjugate score, P < 0.005). Using the results from both scales, a score of >or=9 in an infant examined at >or=36 weeks postmenstrual age predicted normal white matter on magnetic resonance examination, with a sensitivity of 84% and a specificity of 100%. These preliminary findings suggest that white-matter injury affects visual function even before term equivalent postmenstrual age.
脑室周围白质软化是早产儿童视力损害的一个危险因素。磁共振成像检测到的弥漫性白质损伤对早期视觉功能的影响尚不清楚。我们制定了两个5分的视觉注视评分，以分析93例出生时胎龄小于34周的早产新生儿的这种临床评估与白质损伤之间的关联。月经后年龄较大与两个注视评分的较高值相关。中度或重度白质损伤的婴儿得分低于无白质损伤的同龄人（视觉注视评分为0.41分，95%置信区间为0.13 - 0.69；共轭评分为0.70分，95%置信区间为0.30 - 1.10，P < 0.005）。使用两个量表的结果，月经后年龄≥36周时检查的婴儿得分≥9分预测磁共振检查白质正常，敏感性为84%，特异性为100%。这些初步研究结果表明，白质损伤甚至在足月等效月经后年龄之前就会影响视觉功能。
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