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人类副肠孤病毒中枢神经系统感染与幼儿粗大运动神经发育的纵向关联。

Longitudinal Association Between Human Parechovirus Central Nervous System Infection and Gross-Motor Neurodevelopment in Young Children.

机构信息

From the Department of Pediatrics, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.

Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, The Netherlands.

出版信息

Pediatr Infect Dis J. 2019 Feb;38(2):110-114. doi: 10.1097/INF.0000000000002052.

Abstract

BACKGROUND

A paucity of studies investigated the association between human parechovirus (HPeV) central nervous system (CNS) infection and motor and neurocognitive development of children. This study describes the gross-motor function (GMF) in young children during 24 months after HPeV-CNS infection compared with children in whom no pathogen was detected.

METHODS

GMF of children was assessed with Alberta Infant Motor Scale, Bayley Scales of Infant and Toddler Development or Movement Assessment Battery for Children. We conducted multivariate analyses and adjusted for age at onset, maternal education and time from infection.

RESULTS

Of 91 included children, at onset <24 months of age, 11 had HPeV-CNS infection and in 47 no pathogen was detected. Nineteen children were excluded because of the presence of other infection, preterm birth or genetic disorder, and in 14 children, parents refused to consent for participation. We found no longitudinal association between HPeV-CNS infection and GMF (β = -0.53; 95% confidence interval: -1.18 to 0.07; P = 0.11). At 6 months, children with HPeV-CNS infection had suspect GMF delay compared with the nonpathogen group (mean difference = 1.12; 95% confidence interval: -1.96 to -0.30; P = 0.03). This difference disappeared during 24-month follow-up and, after adjustment for age at onset, both groups scored within the normal range for age. Maternal education and time from infection did not have any meaningful influence.

CONCLUSIONS

We found no longitudinal association between HPeV-CNS infection and GMF during the first 24-month follow-up. Children with HPeV-CNS infection showed a suspect GMF delay at 6-month follow-up. This normalized during 24-month follow-up.

摘要

背景

研究人类肠道病毒(HPeV)中枢神经系统(CNS)感染与儿童运动和神经认知发育之间的关系的研究很少。本研究描述了与未检测到病原体的儿童相比,HPeV-CNS 感染后 24 个月内幼儿的粗大运动功能(GMF)。

方法

使用 Alberta 婴儿运动量表、贝利婴幼儿发育量表或儿童运动评估电池评估儿童的 GMF。我们进行了多变量分析,并根据发病年龄、母亲教育程度和感染后时间进行了调整。

结果

在 91 名纳入的儿童中,发病年龄<24 个月,11 名患有 HPeV-CNS 感染,47 名未检测到病原体。19 名儿童因存在其他感染、早产或遗传障碍而被排除在外,14 名儿童的父母拒绝同意参与。我们没有发现 HPeV-CNS 感染与 GMF 之间存在纵向关联(β=-0.53;95%置信区间:-1.18 至 0.07;P=0.11)。在 6 个月时,与非病原体组相比,患有 HPeV-CNS 感染的儿童 GMF 延迟(平均差异=1.12;95%置信区间:-1.96 至-0.30;P=0.03)。在 24 个月的随访期间,这种差异消失了,并且在发病年龄调整后,两组的评分均在年龄的正常范围内。母亲教育程度和感染后时间没有任何有意义的影响。

结论

在最初的 24 个月随访期间,我们没有发现 HPeV-CNS 感染与 GMF 之间存在纵向关联。患有 HPeV-CNS 感染的儿童在 6 个月随访时出现 GMF 延迟,但在 24 个月随访期间恢复正常。

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