先天性心脏病对脑发育的影响。
Effects of congenital heart disease on brain development.
作者信息
McQuillen Patrick S, Goff Donna A, Licht Daniel J
机构信息
Department of Pediatrics, Division of Critical Care, University of California, San Francisco, CA, United States.
出版信息
Prog Pediatr Cardiol. 2010 Aug 1;29(2):79-85. doi: 10.1016/j.ppedcard.2010.06.011.
Abstract
Brain and heart development occurs simultaneously in the fetus with congenital heart disease. Early morphogenetic programs in each organ share common genetic pathways. Brain development occurs across a more protracted time-course with striking brain growth and activity-dependent formation and refinement of connections in the third trimester. This development is associated with increased metabolic activity and the brain is dependent upon the heart for oxygen and nutrient delivery. Congenital heart disease leads to derangements of fetal blood flow that result in impaired brain growth and development that can be measured with advanced magnetic resonance imaging. Delayed development results in a unique vulnerability to cerebral white matter injury in newborns with congenital heart disease. Delayed brain development and acquired white matter injury may underlay mild but pervasive neurodevelopmental impairment commonly observed in children following neonatal congenital heart surgery.
摘要
患有先天性心脏病的胎儿，其大脑和心脏同时发育。每个器官早期的形态发生程序共享共同的遗传途径。大脑发育过程更为漫长，在孕晚期会出现显著的大脑生长以及依赖活动的连接形成和优化。这种发育与代谢活动增加相关，并且大脑依赖心脏输送氧气和营养物质。先天性心脏病会导致胎儿血流紊乱，进而导致大脑生长和发育受损，这可以通过先进的磁共振成像检测到。发育延迟会使患有先天性心脏病的新生儿特别容易发生脑白质损伤。大脑发育延迟和后天性白质损伤可能是新生儿先天性心脏手术后儿童中常见的轻度但普遍存在的神经发育障碍的基础。
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