| Cerebral palsy is one of the common causes of childhood disability.Data research shows that the incidence of cerebral palsy among children aged 1 to 6 in China is 2.48 ‰ and the prevalence is about 2.46 ‰.The disease seriously affects the independence of children's daily life,their ability to integrate into society and quality of life,and is not conducive to improving the quality of our population.In addition,because cerebral palsy cannot be completely cured,long-term rehabilitation treatment is a great psychological,psychological and economic burden for individuals,families,and society,which has also caused a series of social problems.Children with cerebral palsy often have malnutrition,so children with cerebral palsy have lower height,weight,body fat,and muscle content than children with normal growth and development.Nutritional factors are the main factors affecting the growth and development of children with cerebral palsy,and the central nervous system is damaged,which causes difficulty in feeding and swallowing disorders.Other non-nutritive factors that can cause the growth and development of children with cerebral palsy include the severity of the disease,age,abnormal hormone secretion,and environmental factors.The therapeutic effect of rehabilitation for children with cerebral palsy is closely related to their nutritional status,but there are currently few reports on the assessment of children's nutritional status and their growth and development.This study helps us to strengthen the nutritional status of children with cerebral palsy by evaluating the growth and development of children with cerebral palsy.The study provided a theoretical basis for increasing nutritional interventions for children with cerebral palsy and laid a solid foundation for future clinical applications.Insulin-like growth factor 1(IGF-1)is a peptide-protein substance similar in molecular structure to insulin.It is a member of a large family of growth factors and has insulin-like anabolic effects.Many scholars at home and abroad have researched IGF-1 through mice in the diagnosis and treatment of neurological diseases,which is of great significance.At present,the assessment of the degree of neurological damage to cerebral palsy and the effect of diagnosis and rehabilitation are mainly based on clinical symptoms and evaluation items,and lack of specific serological indicators This study also explores the serum insulin-like growth factor(IGF-1)content in children with different cerebral palsy and analyzes its clinical significance,which has certain reference value for the diagnosis and treatment effect evaluation of children with cerebral palsy.Objective:Assess the nutritional status of children with cerebral palsy,related factors affecting the nutritional status of children with cerebral palsy,and whether nutritional interventions have improved the growth and development of children with cerebral palsy.To investigate the serum insulin-like growth factor 1(IGF-1)content in children with cerebral palsy and analyze its clinical significance.Methods:From May 2018 to May 2019,95 children with cerebral palsy and 95 children who came to our hospital for normal physical examination were admitted to Henan Maternal and Child Health Hospital(the Third Affiliated Hospital of Zhengzhou University),and their weights,heights,or lengths were measured.Head circumference and complete the questionnaire and medical record collection.In the morning,2 ml of venous blood was taken on an empty stomach and IGF-1 was measured.Children with cerebral palsy were assessed with GMFM gross motor development scale and Gesell development scale for macromotor and psychomotor development levels.The Z score was used to evaluate the growth and development and nutritional status of children with cerebral palsy,and compared with the children in the normal control group.The gross motor function grading system was used to divide the 95 children with cerebral palsy into mild(grade I n=32),moderate(grade?-? n=42),and severe(grade ?-? n=21).The growth and development indexes of children with cerebral palsy of different severity were compared.During the hospitalization of children with cerebral palsy,nutrition guidance and nutrition support treatment are given on the basis of conventional rehabilitation treatment.Parents are required to record the child's diet every day,including food type,amount of food,and time of eating..During the hospital stay,check the dietary situation of the children recorded by parents every week,and answer the parents' daily questions about dietary feeding.And oral nutritional supplements for infants were given nutritional intervention,1 packet(12g)per day,50ml warm water for rinsing,once a day.During the home rehabilitation period,a follow-up call will be conducted once a week after discharge from the hospital.Parents are urged to allow their children to eat a balanced diet and improve compliance with interventions.After 3 months of nutrition intervention treatment,nutrition evaluation was performed again,and monitoring of the improvement of growth and development indicators provided guidance for improving the rehabilitation effect of children.For the study group and the normal control group,2 ml of venous blood was taken on an empty stomach in the morning and placed in a separation tube,centrifuged at 3000 r/min for 10 min in a TD4C desktop low-speed centrifuge,and serum was obtained.Results:A total of 95 children with cerebral palsy were included in this study.The normal control group selected 95 normal children who came to our hospital in the same period.The physical growth of children with cerebral palsy was significantly lower than that of the normal control group,with normal nutrition 72.1%and malnutrition 27.9%.children with cerebral palsy and normal children have a weight-for-age z-score(WAZ),a height-for-age z-score(HAZ)and a weight-for-height z-score(WHZ)Age-specific head circumference-for-age z-score(HCZ)had statistically significant differences in growth and development indicators(P<0.05).The differences in WAZ,HAZ,WHZ,and HCZ in children with cerebral palsy of different severity were compared.The distribution of growth and development indicators was not the same in each group,and the differences were statistically significant(P<0.05).Cerebral palsy children's growth and development indicators are lower than normal children,and the severity of the disease has a negative impact on growth and development.The cerebral palsy group personalized nutrition intervention treatment group had significant difference in growth and development indexes WAZ and WHZ before and after treatment(P<0.05),and there was no significant difference in HAZ and HCZ(P>0.05).The differences in serum IGF-1 levels between the cerebral palsy group and the control group were statistically significant(P<0.05);the IGF-1 levels in children with cerebral palsy were significantly lower than those in the control group(P<0.05).With the increase of IGF-1 level,children with cerebral palsy,except for the ability to adapt,had large movements,fine movements,speech and social behavior scores,and GMFM scores significantly increased(P<0.05).Conclusion:1.The growth and development indicators of cerebral palsy children are lower than normal children,suggesting that they are more prone to malnutrition.2.Compare cerebral palsy children with different disease severity.The severity of cerebral palsy has a negative effect on the physical growth and development of children.3.Personalized nutrition intervention can promote the growth and development of children with cerebral palsy.4.Correlation between serum IGF-1 concentration and intelligence and motor development level in children with cerebral palsy... |
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