年龄相关的腰椎穿刺开口压力变化：对儿童的解释意义

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development Pub Date : 2025-03-19 DOI:10.1016/j.braindev.2025.104347

Juan David Farfán-Albarracín , Cristina Lorena Ramírez-Sierra , Oscar Mauricio Espitia Segura , Ana Maritza Bedoya Morales , Sofy Helena Pérez Cárdenas , Jennifer Julieth Guzmán-Porras , Luisa Fernanda Lopéz Mora , Mateo Humberto Ramírez Salazar , Leydi Alexandra Ceballos Inga , María Camila Rueda-Rodríguez , Hugo Andrés Téllez Prada , Juan David Sanchez Rincón , Juan Camilo Castro Rubio , Ingrid Lemus Espitia , Juan David Guevara-Ramos

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引用次数: 0

摘要

腰椎穿刺开孔压力（LP）是诊断各种神经系统疾病的重要参数。儿童的压力可能因年龄而异。本研究旨在分析儿童LP开口压力随年龄的变化。方法对2017年2月至2023年3月期间进行的所有lp进行分析。排除有开放压力改变因素的患者。进行描述性分析，并进行均值和中位数比较、局部回归和分位数回归。为了确定最相关的分界点，采用了图形分析。结果中位开孔压力为21.0 cm H2O，第10百分位（P10）为10，第90百分位（P90）为32。开启压力随年龄增长而增加。图形分析显示在96个月时有显著的截断点。1 ~ 96月龄的中位开压为19.2 cm H2O， P10为8，P90为28.9。对于96个月以上的儿童，中位值为22 cm H2O， P10为11.8，P90为35。结论儿童开口压力随年龄不同而不同，性别差异不显著。图形分析表明，96月龄是一个重要的分界点。超过这个年龄，可以使用标准值，直到96个月的年龄，但是，有必要进行参考值的研究。单独的开口压力不足以诊断儿童颅内高压。

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Age-related variations in opening pressure in lumbar puncture: Implications for its interpretation in children

Introduction

Opening pressure in lumbar puncture (LP) is an important parameter in the diagnosis of various neurological diseases. In children pressures may vary according to age. This study aimed to analyze the variation of opening pressure in LP according to age in children.

Methods

All LPs performed between February 2017 and March 2023 were analyzed. Patients with modifying factors for opening pressure were excluded. Descriptive analysis was conducted, along with a comparison of means and medians, local regression, and quantile regression. To identify the most relevant cutoff points, graphical analyses were employed.

Results

The median opening pressure was 21.0 cm H₂O, with a 10th percentile (P10) of 10 and a 90th percentile (P90) of 32. An increase in opening pressure with age was found. Graphical analysis revealed a significant cutoff point at 96 months. The median opening pressure from 1 to 96 months of age was 19.2 cm H₂O, with a P10 of 8 and a P90 of 28.9. For children older than 96 months, the median was 22 cm H₂O, with a P10 of 11.8 and a P90 of 35.

Conclusion

Opening pressures in children vary with age, with no differences related to sex. Graphical analysis indicates that 96 months of age is an important cutoff point. Above this age, standard values could be used, up to 96 months of age, however, it is necessary to conduct studies for reference values. Opening pressure alone is not sufficient for the diagnosis of intracranial hypertension in children.

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来源期刊

Brain & Development 医学-临床神经学

CiteScore

3.60

自引率

0.00%

发文量

153

审稿时长

50 days

期刊介绍： Brain and Development (ISSN 0387-7604) is the Official Journal of the Japanese Society of Child Neurology, and is aimed to promote clinical child neurology and developmental neuroscience. The journal is devoted to publishing Review Articles, Full Length Original Papers, Case Reports and Letters to the Editor in the field of Child Neurology and related sciences. Proceedings of meetings, and professional announcements will be published at the Editor''s discretion. Letters concerning articles published in Brain and Development and other relevant issues are also welcome.