Abstract: 【Objective】 To evaluate the burden of comorbidities in a sample of children with spastic cerebral palsy and stratified according to both neurologic subtype and functional capability with respect to gross motor skills. 【Methods】 Scpchild registry and systematic management database was utilized to identify children over 4-year-old with Spastic cerebral palsy from Feb 2008 to Sep 2010. 172 children (male 109 ,female 63) were involved. The average age was 8.0 years old. Information on neurologic subtype classified according to the qualitative nature and topographic distribution of the motor impairment on neurologic examination, Gross Motor Function Classification System (GMFCS) categorization of motor skills, and the presence of certain comorbidities(epilepsy, visual impairment, hearing impairment and speech disorder) was obtained. 【Results】 The incidence of epilepsy was higher in children with hemiplegia or quadriplegia than those with diplegia. The incidence of visual impairment was higher in children with diplegia and quadriplegia than those with hemiplegia. The incidence of single speech disorder or multiple comorbidities was higher in children with quadriplegia. The frequency of multiple comorbidities was higher in children at GMFCS level IV～V than those at level I~III. 【Conclusions】 The frequency of comorbidities in children with spastic cerebral palsy is correlated with the neurologic subtype and the gross motor function level. The incidence of multiple comorbidities is higher in children with more severe functional impairment.

Key words: cerebral palsy, neurologic subtype, spastic comorbidities, Gross Motor Function Classification System, ICF

摘要： 【目的】 研究痉挛型脑瘫儿童常见伴随症状与瘫痪类型及粗大运动功能分级的关系。 【方法】 研究对象均来自2008年2月-2010年9月间加入scpchild脑瘫登记与系统管理数据库的大于4岁痉挛型脑瘫儿童,共计172名,其中男109例,女63例,平均年龄8.0岁,分析瘫痪类型、粗大运动功能分级(Gross Motor Function Classification System ,GMFCS)与常见伴随症状(癫痫、视觉障碍、听觉障碍、言语障碍)的关系。 【结果】 偏瘫和四肢瘫儿童的癫痫发生率明显高于双瘫,双瘫、四肢瘫儿童的视觉障碍明显多于偏瘫,四肢瘫儿童的言语障碍明显多于偏瘫和双瘫。四肢瘫儿童伴发多重障碍明显多于双瘫和偏瘫,GMFCS分级越高伴发多重障碍的发生率也越高,GMFCS分级I～III级较IV～V级的脑瘫儿童伴随症状明显发生较少。 【结论】 痉挛型脑瘫儿童伴随症状的发生率与脑瘫类型及粗大运动功能分级有关,在重症脑瘫儿童中伴发多重障碍的发生率明显增高。

关键词: 脑性瘫痪, 瘫痪类型, 伴随症状, 粗大运动功能分级, ICF