Analysis Of Clinical Characteristics And Risk Factors Of Patients With Cerebral Palsy

Objective1.To analyze the clinical characteristics of patients complicated with cerebral palsy.2.To analyze the relationship between risk factors and cerebral palsy patients,and to analyze the relationship between the brain MRI and cerebral palsy risk factors.Methods1.A total of 2100 cases of CP patients were retrospectively analyzed,and all of them came from the Department of Functional Neurosurgery of the General Hospital of Chinese People’s Armed Police Forces between October2012 and May 2016.All the cases were confirmed as of diagnosis of CP based on the detailed medical history,magnetic resonance imaging and physical examination.A control group of 2100 age and sex matched patients was randomly obtained from the obstetric medical records data base as a comparison group.2.Detailed clinical history,relevant data and risk factors were retrospectively analyzed.The data of this study were analyzed using SPSS software version 21.0.A Chi-squared test was used to compare the case and control groups’ risk factors.Multivariate logistic regression was used to analyze the independent risk factors.The 95% confidence intervals for crude odds ratios were also calculated.The relationship between brain MRI and risk factors was analyzed by Chi-squared test.P<0.05 was considered statistically significant.Results1.The CP patients in this study ranged from 3 months old to 26 years old,the median(Q25,Q75)age of the case group at baseline was 6(3,12)years.There were 1390 males(66.19%)and 710 females(33.81%),which resulted in a sex ratio of 1.96:1,respectively.The median(Q25,Q75)age of the control group was 6(3,12)years.There were 1355 males(64.52%)and 745 females(35.48%)which resulted in a sex ratio of 1.82:1.2.Among 2100 patients in the case group,spastic CP was the most prevalent type of CP(74.10%),which occurred more frequently compared to dyskinetic CP(10.38%),ataxic CP(4.19%)and mixed CP(11.33%).The cases covered all GMFCS levels and the majority of the GMFCS levels were GMFCS II(40.62%)and III(38.67%).Among the 2100 patients,the abnormal rate of brain MRI result was 82.17%,in which periventricular leukomalacia(27.90%),enlargement of the lateral ventricles(13.14%),brain atrophy(10.81%),delayed myelination(10.24%)was the common type.3.In 9.28% of the patients,no clear risk factors were revealed.Prenatal risk factors were revealed in 37.89% of 2100 patients,perinatal risk factors were revealed in 39.64% cases and postnatal risk factors were revealed in22.47% cases.Asphyxia,prematurity,pathologic jaundice,low birth weight,dystocia,multiple births,advanced maternal age,infection during pregnancy,and neonatal intracranial hemorrhage were variables found to be significantly associated with cerebral palsy between groups(P<0.05).Multivariate Logistic regression analysis showed that asphyxia,prematurity,pathologic jaundice,low birth weight,multiple births,advanced maternal age,gestational hypertension or pre-eclampsia,and neonatal intracranial hemorrhage were independent risk factors for CP,which were the focus in further analyses.There was a significant difference in PVL,enlargement of the lateral ventricles,schizencephaly and prematurity(P<0.05).There was a significant difference in delayed myelination,PVL,focal cerebral ischemia and hypoxia asphyxia(P<0.05).There was a significant difference in basal ganglia damage,focal cerebral ischemia and pathologic jaundice(P<0.05).Conclusion1、In the current study,the gender ratio is 1.96:1,which indicates that male CP patients outnumber female CP patients.Spastic was the most common type CP in our study,followed by mixed type and GMFCS levels were mostly grade Ⅱ and Ⅲ.Periventricular leukomalacia,enlargement of the lateral ventricles and brain atrophy were the common types of brain MRI.2、Our findings confirmed that several risk factors contributed to the cause of CP and prenatal factors were increasingly common.Asphyxia,prematurity,pathologic jaundice,low birth weight,multiple births,advanced maternal age,gestational hypertension or pre-eclampsia,and neonatal intracranial hemorrhage were important independent risk factors for CP.MRI has important clinical significance in children with cerebral palsy and its changes are closely related to CP risk factors.Early detection and a CP education program for the public are recommended.