早产儿胼胝体生长率与智力运动发育的相关性研究

Correlation between growth rate of corpus callosum and neuromotor development in preterm infants

摘要:

目的 通过超声检测VLBW早产儿胼胝体生长率,为早期评价和改善脑发育提供参考。方法 选取120例胎龄小于33周早产儿,分为26~29⁺⁶周组(64例),30~32⁺⁶周组(56例),比较两组胼胝体生长率,分析胼胝体长度与小脑蚓部长度之间的关系,胼胝体生长率与临床因素的关系及其与智能发育之间的关系。结果 早产儿胼胝体生长率于生后2周下降,26~29⁺⁶周组患儿生后3周~、5周~及7周~纠正胎龄40周时胼胝体生长低于30~32⁺⁶周组(P< 0.05)。胼胝体长度与小脑蚓部长度之间呈性线正相关。小于胎龄儿(SGA)生后2周内胼胝体生长率较差(P< 0.05)。12例智力发育严重异常早产儿胼胝体生长率于生后3~6周低于非严重异常组;5例运动发育严重异常早产儿胼胝体生长率于生后3~6周低于非严重异常组(P< 0.05)。结论 早产儿生后2~6周胼胝体生长率下降,可使其发生神经运动发育严重异常的危险性增加。

Abstract:

Objective To investigate the growth rate of corpus callosum by cranial ultrasound in very low birth weight preterm infants and to provide a reference for early evaluation and improvement of brain development. Methods A total of 120 preterm infants under 33 weeks' gestation were recruited and divided into 26-29⁺⁶ weeks group (n=64) and 30-32⁺⁶ weeks group (n=56) according to the gestational age. The growth rate of corpus callosum was compared between the two groups. The correlation between the corpus callosum length and the cerebellar vermis length and the relationship of the growth rate of corpus callosum with clinical factors and the neuromotor development were analyzed. Results The growth rate of corpus callosum in preterm infants declined since 2 weeks after birth. Compared with the 30-32⁺⁶ weeks group, the 26-29⁺⁶ weeks group had a significantly lower growth rate of corpus callosum at 3-4 weeks after birth, at 5-6 weeks after birth, and from 7 weeks after birth to 40 weeks of corrected gestational age. There was a positive linear correlation between the corpus callosum length and the cerebellar vermis length. Small-for-gestational age infants had a low growth rate of corpus callosum at 2 weeks after birth. The 12 preterm infants with severe abnormal intellectual development had a lower growth rate of corpus callosum compared with the 108 preterm infants with non-severe abnormal intellectual development at 3-6 weeks after birth. The 5 preterm infants with severe abnormal motor development had a significantly lower growth rate of corpus callosum compared with the 115 preterm infants with non-severe abnormal motor development at 3-6 weeks after birth. Conclusions The decline of growth rate of corpus callosum in preterm infants at 2-6 weeks after birth can increase the risk of severe abnormal neuromotor development.