目的 分析北京地区4~12月龄儿童的头颅形态与神经心理发育之间的相关性,为临床预防和干预提供科学依据。 方法 采用方便抽样方法选取2021年11月—2023年11月于首都儿科研究所儿童保健中心门诊常规体检,同时进行头颅形态测量及儿童神经心理行为检查量表(2016版)检查的1 407名4~12月龄儿童为研究对象。采用单因素方差分析对不同头颅形态、不同斜径差(CVA)儿童的五大能区发育水平进行比较,通过多元线性回归分析CVA与发育商的相关性。结果 1)调查的1 407名儿童中,头颅形态正常1 004名(71.4%)、斜头异常182例(12.9%)、舟状头149例(10.6%)、短头异常72例(5.1%);4~6月龄组儿童头颅形态异常检出率最高,为31.0%(171/551),10~12月龄最低,为23.5%(89/378),差异有统计学意义(χ2=6.73,P=0.035)。2)不同头颅形态组间两两比较显示,斜头异常组儿童大运动、精细动作发育商低于正常儿童,差异有统计学意义(P＜0.01);舟状头组儿童大运动发育商低于正常儿童,差异有统计学意义(P＜0.01);短头异常组儿童大运动、精细动作、适应能力发育商低于正常儿童,差异有统计学意义(P＜0.05)。CVA＞10mm组儿童大运动、精细动作、适应能力、语言和社交行为发育商均低于CVA≤10mm组,差异有统计学意义(t=13.74、17.84、14.90、8.78、17.07,P＜0.01)。3)线性回归结果显示儿童大运动、精细动作、适应能力发育商与头颅CVA呈负相关(β=-0.32、-0.48、-0.44,P＜0.05)。结论 头颅形态异常儿童运动能力落后于正常儿童,大运动、精细动作、适应能力发育商与测量参数CVA呈负相关,CVA＞10mm儿童更加需要进行全面神经心理发育评估,尽早干预治疗。
Abstract
Objectives To analyze the correlation between cranial morphology and neuropsychological development in infants aged 4 - 12 months in Beijing, in order to provide a scientific basis for clinical prevention and intervention. Methods A convenience sampling method was used to select 1 407 infants aged 4 - 12 months who underwent routine health examinations at the Center of Child Healthcare, Capital Institute of Pediatrics between November 2021 and November 2023.All participants received cranial morphology measurements and neurodevelopmental assessments using the Children's Neuropsychological and Behavioral Scale (2016 Edition).One-way ANOVA was used to compare developmental quotients (DQs) across five functional domains among different cranial morphology groups and varying cranial vault asymmetry (CVA) differences.Multiple linear regression was employed to analyze the correlation between CVA and DQs. Results 1) Among the 1 407 infants, 1 004 (71.4%) had normal cranial morphology, while 182 (12.9%) had plagiocephaly, 149 (10.6%) had scaphocephaly, and 72 (5.1%) had brachycephaly.The highest detection rate of cranial abnormalities was in the 4- to 6-month group (31.0%,171/551), whereas the lowest was in the 10- to 12-month group (23.5%,89/378), with a statistically significant difference (χ2=6.73, P=0.035).2) Pairwise comparisons revealed that infants with plagiocephaly exhibited significantly lower DQs in gross motor and fine motor skills than those with normal cranial morphology (P<0.01).The scaphocephaly group showed lower gross motor DQs (P<0.01), while the brachycephaly group demonstrated significantly lower DQs in gross motor, fine motor, and adaptive abilities (P<0.05).Infants with CVA >10mm had significantly lower DQs in gross motor, fine motor, adaptive, language, and social behavior domains compared to those with CVA ≤10mm (t=13.74, 17.84, 14.90, 8.78, 17.07, P<0.01).3) Linear regression analysis indicated that gross motor, fine motor, and adaptive DQs were negatively correlated with CVA (β=-0.32, -0.48, -0.44, P<0.05). Conclusions Infants with abnormal cranial morphology exhibit delayed motor development compared to their normal counterparts.Gross motor, fine motor, and adaptive DQs are negatively correlated with CVA.Infants with CVA >10mm require comprehensive neurodevelopmental assessment and early intervention.
关键词
头颅形态 /
头颅形态异常 /
斜径差 /
发育商 /
婴儿
Key words
cranial morphological /
deformational plagiocephaly /
cranial vault asymmetry /
developmental quotient /
infants
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基金
国家自然科学基金面上项目(82273645);北京市自然科学基金(7232235);北京市医院管理中心“登峰”计划(DFL20221103);高层次公共卫生技术人才建设(学科带头人-02-19);北京市自然科学基金-海淀原始创新联合基金(L232121);首都儿科研究所临床培育专项(LCYJ-2023-17)
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