摘要目的 了解斜头畸形婴儿的头型特征及其形态参数之间的相关性.方法 选择2016年1至10月于广州市妇女儿童医疗中心康复门诊就诊的104例斜头畸形和头颅外观正常的4～12月龄的婴儿进行头型特征性分析.104例中男74例,女30例.存在斜头畸形特征的婴儿73例(斜头组),其中男53例,女20例;年龄(7.07±2.23)个月.头颅外观正常婴儿31例(对照组),其中男21例,女10例;年龄(8.29±2.81)个月.应用Spectra scanner 2.0激光扫描数据采集系统进行头型扫描和数据采集,头颅形态特征的分析参数采用头部比率(cephalic ratio,CR)、径向对称指标(radial symmetry index,RSI)、对角线差值(oblique diagonal difference,ODD)和颅顶不对称性指数(cranial vault asymmetry index,CVAI).通过独立样本t检验和Pearson相关性分析确定不同月龄、不同性别斜头畸形婴儿的头颅形态特征及各参数之间的相关性.在所有入选的婴儿中,4～7月龄46例(斜头畸形36例,头型正常10例)、＞7～ 10月龄34例(斜头畸形24例,头型正常10例)、＞10～ 12月龄24例(斜头畸形13例,头型正常11例).结果 4～7月龄、＞7 ～10月龄斜头组婴儿的CR值均显著高于对照组[(91.32±5.60)％比(80.73±2.68)％、(90.31±6.22)％比(84.14±3.57)％],差异均有统计学意义(t=-5.765、-2.924,均P＜0.05);＞10～ 12月龄斜头组CR值与对照组比较,差异无统计学意义(t=-1.917,P=0.060).各月龄斜头组RSI、ODD、CVAI值均显著高于对照组[(46.40±13.59) mm比(16.13 ±4.18) mm、(11.84 ±3.58) mm比(3.44±1.59) mm、7.92±2.43比2.34±1.07],差异均有统计学意义(t=-17.210、-16.579、-16.304,均P＜0.001).斜头组男婴和女婴的CR、RSI、ODD、CVAI数值均显著高于对照组,差异均有统计学意义(均P ＜0.001);对照组、斜头组组内男女婴之间CR、RSI、ODD、CVAI数值比较,差异均无统计学意义(均P＞0.05).Pearson相关性分析显示,各月龄斜头组CR与RSI、ODD、CVAI均无相关性(均P＞0.05);各月龄斜头组RSI、ODD、CVAI间均存在正相关(r=0.940、0.912、0.973,均P＜0.001).结论 斜头畸形婴儿在存在头部外观不对称的情况下,可能同时存在前后径短的问题.斜头畸形婴儿的RSI、ODD、CVAI某一项数值越大,其余2项的数值亦随之增大,斜头畸形程度也越严重.

abstractsObjective To study the characteristics of the head shape and correlations among the shape parameters in infants at the plagiocephaly.Methods One hundred and four infants at the age of 4-12 months from Department of Rehabilitation,Guangzhou Women and Children's Medical Center with plagiocephaly or normal head shape from January to October 2016 were selected for head shape characteristic analysis.Seventy-four males and 30 females were included.Seventy-three infants (53 males and 20 females) with plagiocephaly were plagiocephaly group with age of (7.07 ±2.23) months.Thirty-one infants (21 males and 10 females) with normal head shape were control group with age for (8.29 ± 2.81) months.The Spectra scanner 2.0 was applied to acquire head shape parameters including cephalic ratio (CR),radial symmetry index (RSI),oblique diagonal difference (ODD),and cranial vault asymmetry index (CVAI).The correlation between the head shape characteristics and shape parameters of infants in different month ages and gender with plagiocephaly were analyzed through independent sample t-test and Pearson correlation analysis.Among all the enrolled infants,there were 46 infants in 4-7 months (36 cases with plagiocephaly and 10 cases with normal head shape),34 infants in ＞ 7-10 months (24 cases with plagiocephaly and 10 cases with normal head shape),and 24 infants in ＞ 10-12 months (13 cases with plagiocephaly and 11 cases with normal head shape).Results CR in 4-7 months group and ＞ 7-10 months of plagiocephaly group were all significantly higher than that in control group [(91.32 ± 5.60) ％ vs.(80.73 ± 2.68) ％,(90.31 ± 6.22) ％ vs.(84.14 ± 3.57) ％],and the differences were all statistically significant (t =-5.765,-2.924,all P ＜ 0.05).The difference was not significant of the CR in ＞ 10-12 months plagiocephaly group compared with that in control group (t =-1.917,P =0.060).RSI,ODD,and CVAI of plagiocephaly group in all ages were significantly higher than those in control group [(46.40 ± 13.59) mmvs.(16.13 ±4.18) mm,(11.84±3.58) mmvs.(3.44±1.59) mm,7.92±2.43 vs.2.34± 1.07],and the differences were all statistically significant (t =-17.210,-16.579,-16.304,all P ＜ 0.001).CR,RSI,ODD,and CVAI of males and females in plagiocephaly group were respectively higher than those of control group,and the differences were all statistically significant (all P ＜ 0.001).There was no statistical significance in CR,RSI,ODD,CVAI between males and females in plagiocephaly group or control group (all P ＞ 0.05).Pearson correlation analysis revealed that there was no correlation between CR and RSI,ODD,CVAI in any age of plagiocephaly group (all P ＞ 0.05).There was a positive correlation among RSI,ODD,and CVAI in the plagiocephaly group in any age (r =0.940,0.912,0.973,all P ＜ 0.001).Conclusions In the infants with plagiocephaly may exist asymmetric head shape and the shorter length of head at the same time.When one of the values of RSI,ODD and CVAI increases,the other two values increase too with more serious level of plagiocephaly.