Bos A F, van Asperen R M, de Leeuw D M, Prechtl H F
Dept. of Paediatrics, Division of Neonatology, Beatrix Children's Hospital, University Hospital, Groningen, The Netherlands.
Early Hum Dev. 1997 Nov 24;50(1):61-70. doi: 10.1016/s0378-3782(97)00093-5.
The qualitative assessment of general movements (GMs) in preterm infants is a sensitive method to investigate the integrity of the central nervous system. The question arises whether systemic infections affect the quality of GMs in a similar fashion to brain lesions. We were able to provide an answer to this problem in six infants (gestational age 24.4-32.4 weeks, birth weight 600-1660 grams), who had initially normal GMs as analyzed from sequential video-recordings. All infants sustained a proven septicaemia (Candida albicans in two, Staphylococcus aureus in three, a coagulase-negative staphylococcus in one infant). Unintentionally, recordings were also made during the acute phase. The complexity and variability of the GMs remained largely intact in five of the six infants; only one infant had transiently abnormal GMs. Compared with 1 week before the acute phase, the speed and amplitude of the GMs were diminished, giving the GMs a sluggish appearance. One to two weeks after the acute phase of septicaemia, the quality of GMs, i.e. speed and amplitude, had normalized in all infants. This study demonstrates that it is possible to discriminate between abnormal GMs due to cerebral lesions and sluggish GMs due to severe systemic infections, when the complexity of the GMs is considered as the main characteristic for judgement of normality of GM-quality.
对早产儿的一般运动（GMs）进行定性评估是一种用于研究中枢神经系统完整性的敏感方法。问题在于，全身感染是否会以与脑损伤类似的方式影响GMs的质量。我们能够对6名婴儿（胎龄24.4 - 32.4周，出生体重600 - 1660克）的这个问题给出答案，这些婴儿最初的GMs通过连续录像分析显示是正常的。所有婴儿均确诊患有败血症（2例为白色念珠菌，3例为金黄色葡萄球菌，1例为凝固酶阴性葡萄球菌）。在急性期还意外地进行了录像。6名婴儿中有5名的GMs复杂性和变异性基本保持完好；只有1名婴儿的GMs出现短暂异常。与急性期前1周相比，GMs的速度和幅度减小，使GMs呈现出迟缓的外观。败血症急性期后1至2周，所有婴儿的GMs质量，即速度和幅度，均恢复正常。这项研究表明，当将GMs的复杂性视为判断GMs质量正常与否的主要特征时，有可能区分由脑损伤导致的异常GMs和由严重全身感染导致的迟缓GMs。
