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先天性寨卡综合征患儿的运动功能。

Motor function in children with congenital Zika syndrome.

机构信息

Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), Campina Grande, Paraíba, Brazil.

出版信息

Dev Med Child Neurol. 2020 Feb;62(2):221-226. doi: 10.1111/dmcn.14227. Epub 2019 Apr 4.

DOI:10.1111/dmcn.14227
PMID:30945276
Abstract

AIM

To evaluate gross motor function and associated factors in children with congenital Zika syndrome (CZS).

METHOD

Fifty-nine children (30 males, 29 females) with CZS at a mean (SD) age of 14.7 (3.9), months (range 5-29mo) were evaluated using the Gross Motor Function Measure (GMFM) and classified according to the Gross Motor Function Classification System (GMFCS). Neurological damage was evaluated by neuroimaging. The mothers' sociodemographic characteristics and general data on the children were obtained from interviews with the mothers and from the children's medical records. Correlational and multiple regression analyses were performed to identify factors associated with these children's motor function.

RESULTS

In 81% of the children, motor function impairment was severe, classified as GMFCS level V. The overall GMFM score ranged from 5 to 210 (median 18; interquartile range 11), with only four children receiving scores in the D and E dimensions. The factors found to affect motor function were the presence of severe malformations of cortical development and small head circumference at birth.

INTERPRETATION

Although motor impairment may be mild in some children, it is generally severe. Severe malformations of cortical development and small head circumference at birth were factors associated with poorer motor function, reflecting the greater severity of brain damage.

WHAT THIS PAPER ADDS

Motor impairment is severe in most children with congenital Zika syndrome (CZS). Motor skills are adequate or close to adequate for age in 7% of children with CZS. Severe malformations of cortical development are associated with poor motor control. Small head circumference at birth is also associated with poor motor control.

摘要

目的

评估先天性寨卡综合征(CZS)患儿的粗大运动功能及其相关因素。

方法

对 59 名(男 30 名,女 29 名)平均(标准差)年龄为 14.7(3.9)个月(5-29mo)的 CZS 患儿使用粗大运动功能测量表(GMFM)进行评估,并根据粗大运动功能分类系统(GMFCS)进行分类。神经影像学评估神经损伤。通过对母亲进行访谈以及查阅患儿病历,获取母亲的社会人口统计学特征和患儿的一般资料。采用相关和多元回归分析来识别与这些儿童运动功能相关的因素。

结果

81%的患儿存在严重的运动功能障碍,GMFCS 分级为 V 级。GMFM 总评分范围为 5-210(中位数 18;四分位距 11),仅有 4 名患儿在 D 和 E 维度获得分数。影响运动功能的因素为皮质发育严重畸形和出生时头围小。

解释

尽管一些患儿的运动障碍可能较轻,但总体上仍较为严重。皮质发育严重畸形和出生时头围小是与运动功能较差相关的因素,反映了脑损伤的严重程度。

本研究新增内容

先天性寨卡综合征(CZS)患儿的运动障碍多为重度。7%的 CZS 患儿的运动技能处于或接近年龄正常水平。皮质发育严重畸形与运动控制不良相关。出生时头围小也与运动控制不良相关。

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