目的 比较Patel指数模型和Z评分变化法计算胎龄<30周早产儿体重增长速率对其远期神经系统和体格发育预后的预测价值。 方法 回顾性纳入2017年1月—2022年6月在华中科技大学附属同济医学院附属同济医院新生儿科住院治疗并在门诊随访至18月龄以上的胎龄<30周早产儿为研究对象，分别采用Patel指数模型和Z评分变化法计算方法将早产儿分为高速率组和低速率组，并比较Patel指数模型和Z评分变化法对早产儿远期神经系统及体格发育结局的预测价值。 结果 末次平均随访年龄为（23.0±3.6）个月。神经系统发育方面，基于Patel指数模型的低速率组的精细运动能区异常率高于高速率组（P<0.05）；基于Z评分变化法的低速率组的粗大运动能区和精细运动能区异常率高于高速率组，粗大运动能区、精细运动能区及应物能区的发育商低于高速率组（P<0.05）。体格发育方面，两种方法的低速率组和高速率组身长、体重、头围及生长受限发生率比较差异均无统计学意义（P>0.05）。 结论 基于Z评分变化法计算的体重增长速率预测早产儿远期神经系统结局的能力更好，两种方法计算的体重增长速率与远期体格发育结局无明显关系。
Abstract
Objective To investigate the value of weight growth velocity, calculated using the Patel exponential model and the Z-score change method, in predicting the neurological and physical development outcomes of preterm infants with a gestational age of <30 weeks in the long term. Methods A retrospective study was conducted involving preterm infants with a gestational age of <30 weeks who were hospitalized and treated in the Department of Neonatology at Tongji Hospital, Huazhong University of Science and Technology, from January 2017 to June 2022, and were followed up at the outpatient service more than 18 months of age. The preterm infants were divided into high and low rate groups based on the two calculation methods, and the two methods were compared regarding their predictive value for neurological and physical development outcomes in the long term. Results The average age of the last follow-up was (23.0±3.6) months. For neurological development, according to the Patel exponential model, the low rate group exhibited a significantly higher abnormal rate in the fine motor domain compared to the high rate group (P<0.05). Using the Z-score change method, the low rate group had significantly higher abnormal rates in both gross motor and fine motor domains, and significantly lower developmental quotients for gross motor, fine motor, and adaptive behavior domains compared to the high rate group (P<0.05). For physical development, there were no significant differences in body length, body weight, head circumference, or the incidence rate of growth restriction between the low rate and high rate groups identified by either method (P>0.05). Conclusions Weight growth velocity calculated using the Z-score change method is more effective in predicting long-term neurological outcomes in preterm infants, while weight growth velocity derived from both methods shows no significant association with long-term physical development outcomes.
关键词
体重增长速率 /
神经系统发育 /
体格发育 /
早产儿
Key words
Weight growth velocity /
Neurodevelopment /
Physical development /
Preterm infant
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参考文献
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