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制定脑瘫儿童生长障碍特异性参考数据。

Development of disorder-specific normative data for growth in children with cerebral palsy.

机构信息

Faculty of Medicine and University Hospital Cologne, Department of Pediatrics, University of Cologne, Cologne, Germany.

Faculty of Medicine and University Hospital Cologne, Center for Prevention and Rehabilitation, University of Cologne, Unireha, Cologne, Germany.

出版信息

Eur J Pediatr. 2019 Jun;178(6):811-822. doi: 10.1007/s00431-019-03360-5. Epub 2019 Mar 14.

Abstract

The purpose of this study was to create growth-percentiles for Caucasian children with cerebral palsy (CP). The studied parameters were height and age. In a retrospective analysis, we converted measurements collected in our center to create disorder-specific percentiles of normative data. Patients were stratified due to sex (male and female) and to mobility levels using the gross motor function classification system (GMFCS) (A = walking; GMFCS I-III, B = non walking; GMFCS IV-V) into four groups. In total, 2363 measurements in patients 0-18 years were collected. The mean age for group "Am" was 6.8 years (n = 862), group "Bm" 7.6 years (n = 563), group "Af" 7.7 years (n = 600), and group "Bf" 8.2 years (n = 366). The created percentiles for all groups were below the reference percentiles for healthy Caucasian children (KiGGS). The median curve for children with GMFCS levels I-III is slightly above the 3rd percentile, whereas the 50th percentile for GMFCS levels IV-V is mostly below the 3rd KiGGS centile.Conclusion: In conclusion, children with cerebral palsy are smaller than healthy children. The difference between 50th percentile of CP patients compared to healthy children supports the need for the use of disorder-specific growth charts. Those charts can help clinicians differentiate growth disorders in patients with CP. What is Known: • Children with cerebral palsy are shorter than healthy children and height is influenced by level of ambulation. • Currently, only reference percentiles of American children with mixed ethical backgrounds are available to evaluate growth. What is New: • This paper presents disorder-specific reference percentiles for longitudinal growth of Caucasian children with cerebral palsy depending on motor function. • These percentiles allow to asses longitudinal growth in children with cerebral palsy to detect other additional diseases impairing growth.

摘要

这项研究的目的是为患有脑瘫(CP)的白种人儿童创建生长百分位数。研究的参数是身高和年龄。在回顾性分析中,我们转换了在我们中心收集的测量值,以创建特定于疾病的正常数据百分位数。根据性别(男性和女性)和使用粗大运动功能分类系统(GMFCS)(A=行走;GMFCS I-III,B=非行走;GMFCS IV-V)将患者分层,将患者分为四个组。总共收集了 0-18 岁患者的 2363 次测量值。组“Am”的平均年龄为 6.8 岁(n=862),组“Bm”为 7.6 岁(n=563),组“Af”为 7.7 岁(n=600),组“Bf”为 8.2 岁(n=366)。为所有组创建的百分位数均低于健康白种人儿童(KiGGS)的参考百分位数。GMFCS 水平 I-III 的儿童中位数曲线略高于第 3 百分位数,而 GMFCS 水平 IV-V 的 50 百分位数大多低于第 3 KiGGS 百分位数。结论:患有脑瘫的儿童比健康儿童矮小。CP 患者的 50 百分位与健康儿童的差异支持使用特定于疾病的生长图表的必要性。这些图表可以帮助临床医生区分 CP 患者的生长障碍。已知:•脑瘫儿童比健康儿童矮,身高受步行水平的影响。•目前,只有美国混合种族背景儿童的参考百分位数可用于评估生长情况。新内容:•本文介绍了根据运动功能为患有脑瘫的白种人儿童提供的特定于疾病的纵向生长参考百分位数。•这些百分位数可以评估脑瘫儿童的纵向生长情况,以发现其他影响生长的额外疾病。

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