Samsom J F, de Groot L, Hopkins B
Department of Pediatrics, Free University Hospital, Amsterdam, The Netherlands.
Neuropediatrics. 1998 Jun;29(3):127-32. doi: 10.1055/s-2007-973548.
A group of 73 "high risk" preterm infants was studied at the corrected age of 12 weeks. The infants were categorized according to their medical history in 5 classes conform with the "Neonatal Medical Index" (NMI). Only infants with high-risk for developmental discrepancies with a score of NMI > or = III were included in the study. Apart from pediatric follow-up and an age-adequate neurological examination, special emphasis was put on measuring a specific feature in the development of preterm infants: the relationship between active muscle power and passive tone. These two components of muscle power should be in balance with each other to create stable posture and fluent motility and later co-ordination. Discrepancy between active and passive muscle tone was found in all NMI groups studied and was most outspoken in the legs. Infants in NMI IV and V showed a significantly higher incidence of increased passive tone than the infants in NMI III. When the different regions of the body were studied separately, the infants in NMI IV and V showed significantly increased passive tone in the trunk and shoulders (p 0.009) compared to infants in NMI III, which may constitute an alarm signal of deviant development. The main aim of the study was to provide a clinical method for early detection, subtle enough to select infants most at risk for later functional and neurological problems.
一组73名“高危”早产儿在矫正年龄12周时接受了研究。根据他们的病史，这些婴儿按照符合“新生儿医学指数”（NMI）的5个类别进行了分类。只有NMI评分≥III、有发育差异高危风险的婴儿被纳入研究。除了儿科随访和适合年龄的神经学检查外，特别强调测量早产儿发育中的一个特定特征：主动肌肉力量与被动肌张力之间的关系。肌肉力量的这两个组成部分应相互平衡，以形成稳定的姿势、流畅的运动及随后的协调能力。在所研究的所有NMI组中均发现主动肌和被动肌张力之间存在差异，且在腿部最为明显。NMI IV和V组的婴儿被动肌张力增加的发生率明显高于NMI III组的婴儿。当分别研究身体的不同部位时，与NMI III组的婴儿相比，NMI IV和V组的婴儿在躯干和肩部表现出明显增加的被动肌张力（p<0.009），这可能构成发育异常的警报信号。该研究的主要目的是提供一种临床方法用于早期检测，该方法要足够精细，以筛选出最有可能出现后期功能和神经问题的婴儿。
