早产儿胼胝体生长率与智力运动发育的相关性研究

刘瑞可, 孙洁, 胡丽燕, 刘芳

中国当代儿科杂志 ›› 2015, Vol. 17 ›› Issue (8) : 841-846.

PDF(1829 KB)
HTML
PDF(1829 KB)
HTML
中国当代儿科杂志 ›› 2015, Vol. 17 ›› Issue (8) : 841-846. DOI: 10.7499/j.issn.1008-8830.2015.08.016
论著·临床研究

早产儿胼胝体生长率与智力运动发育的相关性研究

  • 刘瑞可1, 孙洁2, 胡丽燕3, 刘芳4
作者信息 +

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

  • LIU Rui-Ke1, SUN Jie2, HU Li-Yan3, LIU Fang4
Author information +
文章历史 +

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.

关键词

胼胝体 / 大脑 / 胎龄 / 早产儿

Key words

Corpus callosum / Brain / Gestational age / Preterm infant

引用本文

导出引用
刘瑞可, 孙洁, 胡丽燕, 刘芳. 早产儿胼胝体生长率与智力运动发育的相关性研究[J]. 中国当代儿科杂志. 2015, 17(8): 841-846 https://doi.org/10.7499/j.issn.1008-8830.2015.08.016
LIU Rui-Ke, SUN Jie, HU Li-Yan, LIU Fang. Correlation between growth rate of corpus callosum and neuromotor development in preterm infants[J]. Chinese Journal of Contemporary Pediatrics. 2015, 17(8): 841-846 https://doi.org/10.7499/j.issn.1008-8830.2015.08.016

参考文献

[1] 李薇, 黄燕, 叶如霞, 等. 早产儿的早期干预对智力、运动发育及脑瘫发生率的影响[J]. 中国妇幼保健, 2011, 22(26): 3411-3413.
[2] Perenyi A, Amodio J, Katz JS, et al. Clinical utility of corpus callosum measurements in head sonograms of preterm infants: a cohort study[J]. BMJ open, 2013, 3(4): e002499.
[3] Anderson NG, Laurent I, Woodward IJ, et al. Detection of impaired growth of the corpus callosum in premature infants[J]. Pediatrics, 2006, 118(3): 951-960.
[4] 刘芳, 刘皎然, 杜志方, 等. 早产儿胼胝体生长率与运动发育迟滞关系的研究[J]. 中国当代儿科杂志, 2008, 10(6): 701-704.
[5] 范存仁. CDCC婴幼儿智能发育测查手册[M]. 北京: 团结出版社, 1988: 9.
[6] 邵肖梅, 叶鸿瑁, 丘小灿. 实用新生儿学[M]. 第4版. 北京:人民卫生出版社, 2011: 675.
[7] Gooijers J, Swinnen SP. Interactions between brain structure and behavior: the corpus callosum and bimanualcoordination[J]. Neurosci Biobehav Rev, 2014, 43(6): 1-19.
[8] Thompson DK, Inder TE, Faggian N, et al. Characterization of the corpus callosum in very preterm and full-term infants utilizing MRI[J]. Neuroimage, 2011, 55(2): 479-490.
[9] Amaniti EM, Hasenpusch-Theil K, Li Z, et al. Gli3 is required in Emx1+ progenitors for the development of the corpus callosum[J]. Dev Biol, 2013, 376(2): 113-124.
[10] 刘瑞可, 刘芳, 李建英, 等. 早产儿与足月儿胼胝体面积的对比研究[J]. 中国当代儿科杂志, 2014, 16(5): 478-482.
[11] 刘皎然, 刘芳, 王菲, 等. 早产儿胼胝体生长率与神经运动发育关系的超声研究[J]. 临床超声医学杂志, 2009, 11(3): 165-167.
[12] 胡原, 陈文娟, 张号绒, 等. 早产儿胼胝体发育的超声监测[J]. 医学影像杂志, 2010, 20(7): 1038-1041.
[13] 胡原, 陈文娟, 何静波, 等. 新生儿胼胝体发育不全的超声诊断[J]. 中国医学影像杂志, 2010, 18(6): 569-572.
[14] Groenendaal F, Lammers H, Smit D, et al. Nitrotyrosine in brain tissue of neonates after perinatal asphyxia[J]. Arch Dis Child Fetal Neonatal Ed, 2006, 91(6): F429-F433.
[15] Zayek MM, Benjamin JT, Maertens P, et al. Cerebellar hemorrhage: a major morbidity in extremely preterm infants[J]. J Perinatol, 2012, 32(9): 699-704.
[16] Limperopoulos C, Soul JS, Haidar H, et al. Impaired trophic interactions between the cerebellum and the cerebrum among preterm infants[J]. Pediatrics, 2005, 116(4): 844-850.
[17] Bodensteiner JB, Johnsen SD. Cerebellar injury in the extremely premature infant: newly recognized but relatively common outcome[J]. J Child Neurol, 2005, 20(2): 139-142.
[18] Graca AM, Geraldo AF, Cardoso K, et al. Preterm cerebellum at term age: ultrasound measurements are not different from infants born at term[J]. Pediatr Res, 2013, 74(6): 698-704.

基金

河北省人口和计划生育委员会计划项目(2012-A15)。


PDF(1829 KB)
HTML

Accesses

Citation

Detail

段落导航
相关文章

/