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基于国家登记数据的脑瘫早期诊断预测因素

Predictors for early diagnosis of cerebral palsy from national registry data.

作者信息

Granild-Jensen Jakob Bie, Rackauskaite Gija, Flachs Esben Meulengracht, Uldall Peter

机构信息

Paediatric Department A, Aarhus University Hospital, Aarhus, Denmark.

National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.

出版信息

Dev Med Child Neurol. 2015 Oct;57(10):931-5. doi: 10.1111/dmcn.12760. Epub 2015 Apr 9.

Abstract

AIM

As early intervention is important in cerebral palsy (CP), an early diagnosis is desirable. The aim of this study was to establish the median diagnostic age of CP and to identify predictors of an early diagnosis in a population-based cohort.

METHOD

Using the Danish National Cerebral Palsy Registry (NCPR), we identified 1291 children with CP (764 males, 527 females) born between 1995 and 2003. The date of diagnosis was defined as the day the parents were told that their child was spastic or had CP. We calculated the age of diagnosis and analysed the following predictors: type of CP, degree of motor disability, cerebral ultrasonography results, epilepsy, gestational age, and degree of cognitive impairment.

RESULTS

We found the overall median corrected diagnostic age of CP to be 11 months. Early diagnosis was associated with the type of CP, presence of epilepsy, a high degree of motor disability, and abnormalities in the cerebral ultrasonography. The gestational age was not associated with the diagnostic age.

INTERPRETATION

The median diagnostic age implies that half of the Danish children with CP will be able to enter an early intervention program before 1 year of age. A late diagnosis was associated with less severe symptoms, and gestational age did not influence the diagnostic age.

摘要

目的

由于早期干预在脑瘫(CP)中至关重要,因此早期诊断很有必要。本研究的目的是确定CP的中位诊断年龄,并在一个基于人群的队列中识别早期诊断的预测因素。

方法

利用丹麦国家脑瘫登记处(NCPR),我们确定了1995年至2003年出生的1291例CP患儿(764例男性,527例女性)。诊断日期定义为父母被告知其孩子患有痉挛或CP的那天。我们计算了诊断年龄,并分析了以下预测因素:CP类型、运动残疾程度、脑超声检查结果、癫痫、胎龄和认知障碍程度。

结果

我们发现CP的总体中位校正诊断年龄为11个月。早期诊断与CP类型、癫痫的存在、高度运动残疾和脑超声检查异常有关。胎龄与诊断年龄无关。

解读

中位诊断年龄意味着一半的丹麦CP患儿能够在1岁前进入早期干预项目。诊断延迟与症状较轻有关,且胎龄不影响诊断年龄。

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