秦巴山区精神发育迟滞儿童生物医学因素分析

目的　确定秦巴山区宁强、柞水、安康调查点精神发育迟滞 (MR)儿童的生物医学因素。方法　由心理学专业人员对调查点儿童做智力筛查 ,对筛出的可疑儿童做适应行为评定、智力诊断、相关的实验室检查及病史调查 ,最后由小儿神经科、妇产科及心理学专家进行病例讨论 ,确定MR儿童的病情程度和病因结构。结果　调查 0～ 14岁儿童共计 74 87人 ,发现MR儿童 2 38人 ,其患病率为 3.18% ,显著高于 1987年全国平均水平 (P <0 .0 0 5 ) ;在MR病情轻重构成方面 ,除安康调查点缺乏统计学意义外 (P >0 .10 ) ,宁强、柞水两点主要以轻度MR占大多数 ,分别为 76 .8%、73.9% ,较全国平均水平 (6 0 .6 % )高 (P <0 .0 5 ) ;在已明确病因的MR病因构成方面 ,宁强、安康两点的情况和全国平均水平相似 ,均以产前及产后原因为主 ,而柞水调查点则主要以产时因素为主 (P <0 .0 1) ;在参与构成MR病因的家庭文化环境方面 ,母亲因素占主导地位 :在母亲为智力低下或文化程度低的家庭中 ,MR的患病率显著增高 (P <0 .0 0 5 )。结论　秦巴山区的MR发生情况仍较严重 ,加强围产期保健 ,规范培训乡村医师 ,改善家庭经济文化状况 ,提高母亲的文化素质是改变这一现状的主要措施

Analysis of biomedical factors of MR children in Qinba mountainous region

Objective To determine the biomedical factors of mental retardation (MR) children in investigation stations Ningqiang, Zhashui and Ankang in Qinba mountainous region. Methods In the very beginning, all the children of the investigation stations were tested with intelligence screening by the psychometricians. Subsequently, the children who were suspected of MR were tested with intelligence diagnosis, evaluation of adaptability and behavior, related lab examination and investigation of history. Finally, discussions were held among the pediatricians, obstetricians and psychologists in order to define the etiology and severity of these MR children. Results Of the 7484 children investigated, 238 children with MR were found. The prevalence rate of MR was 3.18%, which was higher than the average rate of the whole nation in 1987 (P< 0.05). With regard to the severity constitution of all the patients' condition, there was no difference between Ankang ( χ 2= 5.21, P> 0.01) and the whole nation, but MR was mostly mild in Ningqiang (76.8%) and Zhashui (73.9%),which was severer than that of the whole country (60.6%).As for the constitution of MR explicit pathogenesis , the states of Ningqiang and Ankang were similar to the average rate of the whole country with predominant antepartum and intrapartum agent, while the major agent of Zhashui ( χ 2= 10.22, P< 0.01) was that of postpartum. The parents' educational level was an etiological factor of MR, the mother's educational background constituting the major cause. In the families in which the mother had MR or low education, the prevalence rate increased significantly( χ 2= 31.87, P< 0.005). Conclusion The incidence of MR in Qinba mountainous region is still high. Strengthening the health care of perinatal stage, training rural doctors, improving the economic and cultural level of the family, and promoting mothers' educational level are major measures which can change this situation.