精神发育迟滞儿童伴随症状与病因分析

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目的分析精神发育迟滞(MR)的病因、伴随症状及分级的关系,为精神发育迟滞的诊治及预防奠定基础。方法 2003年1月至2006年12月在首都儿科研究所附属儿童医院神经内科就诊的精神发育迟滞患儿共1329例,对其精神发育迟滞的分级、伴随症状及病因进行分析。结果 1329例MR患儿年龄6个月~15岁,平均(3.15±3.12)岁;男女比例为1.88∶1。非特异精神发育迟滞患儿组伴有惊厥及姿势/肌张力异常的发生率明显高于伴有畸形的精神发育迟滞患儿(P<0.05);精神发育迟滞伴有畸形的患儿组,重度MR明显多于非特异精神发育迟滞患儿组(P<0.05)。精神发育迟滞伴有畸形的患儿组病因不明者显著多于非特异精神发育迟滞患儿组(P<0.05);在非特异精神发育迟滞患儿组内,病因明确的MR患儿为重度者明显多于病因不明的重度MR患儿(P<0.05);在精神发育迟滞伴有畸形的患儿组内,其病因明确否与MR分级无显著相关性(P>0.05),其病因以染色体病最多,有65.37%的病例病因不明。结论对于精神发育迟滞合并畸形的患儿首选染色体检查,对于合并有惊厥及姿势/肌张力异常的患儿应考虑染色体病以外的疾病,重度非特异精神发育迟滞患儿较轻度MR患儿容易找到病因。 Objective To analyze the etiology, concomitant symptoms and grading of mental retardation (MR) and lay the foundation for the diagnosis, treatment and prevention of mental retardation. Methods A total of 1329 children with mental retardation from January 2003 to December 2006 were enrolled in the Department of Neurology, Children’s Hospital Affiliated to Capital Institute of Pediatrics, and their mental retardation grade, accompanying symptoms and causes were analyzed. Results 1329 cases of children aged 6 months to 15 years old, with an average (3.15 ± 3.12) years; male to female ratio was 1.88:1. Children with non-specific mental retardation associated with seizures and postural / dystonic abnormalities was significantly higher in children with mental retardation (p <0.05); mental retardation in children with deformity, severe MR significantly more than children with non-specific mental retardation group (P <0.05). The children with mental retardation and deformity had significantly more etiology than those with nonspecific mental retardation (P <0.05). In children with nonspecific mental retardation, those with clear etiology were severe (P <0.05). In children with mental retardation and deformity, the etiology was not significantly correlated with MR grade (P> 0.05), and the etiological factor was based on chromosome Disease is the most, 65.37% of the cases of etiology is unknown. Conclusion For children with mental retardation and deformity, the preferred chromosomal examination should be considered for children with eclampsia and postural / dystonia other than chromosomal disease. Patients with severe nonspecific mental retardation should be considered as susceptible to mild MR Find the cause.
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