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肝移植后儿童和青少年的视觉空间障碍

Visuospatial impairment in children and adolescents after liver transplantation.

作者信息

Haavisto Anu, Korkman Marit, Törmänen Jussi, Holmberg Christer, Jalanko Hannu, Qvist Erik

机构信息

Institute of Behavioural Sciences, University of Helsinki, Pediatric Nephrology and Transplantation, Hospital for Children and Adolescents, Helsinki, Finland.

出版信息

Pediatr Transplant. 2011 Mar;15(2):184-92. doi: 10.1111/j.1399-3046.2010.01451.x. Epub 2010 Dec 29.

Abstract

A minority of children with liver transplants exhibit significant delay in global intelligence; others have specific learning disabilities. More specific data on neurocognitive strengths and weaknesses are lacking. Eighteen children aged 7-16 yr, who had undergone LTx in Finland participated in the study. They were assessed on an average 7.6 (s.d. 4.5, range 1.0-15.0) years post-operatively at a mean age of 11.8 (s.d. 3.1, range 7.2-16.1). A standardized test of intelligence (WISC-III), a neuropsychological test battery (NEPSY-II), and a parental questionnaire on the child's development (FTF) were administered. The neuropsychological test profile of the LTx group was compared with that of a matched control group of healthy children. The LTx children achieved on an average normal FSIQ 94.0 and VIQ 99.6. Their Performance Intelligence Quotient (PIQ 88.9, p=0.043) was, however, significantly lower than the population mean. On neuropsychological assessment, the LTx children scored generally lower than the control group (p=0.004), a difference significant in sub-tests assessing visuospatial and visuoconstructive functions and social perception. No differences emerged in sub-tests of attention and executive functions, memory and learning, or language functions. LTx children are at increased risk for impairment in the visuospatial domain.

摘要

少数接受肝脏移植的儿童在整体智力方面表现出显著延迟;其他儿童则有特定的学习障碍。目前缺乏关于神经认知优势和劣势的更具体数据。18名年龄在7至16岁之间、在芬兰接受肝脏移植的儿童参与了这项研究。他们在术后平均7.6(标准差4.5,范围1.0 - 15.0)年接受评估,平均年龄为11.8(标准差3.1,范围7.2 - 16.1)。进行了一项标准化智力测试(韦氏儿童智力量表第三版)、一套神经心理测试(第二版NEPSY)以及一份关于儿童发育的家长问卷(FTF)。将肝脏移植组的神经心理测试结果与一组匹配的健康儿童对照组进行比较。肝脏移植儿童的平均全量表智商(FSIQ)为94.0,言语智商(VIQ)为99.6。然而,他们的操作智商(PIQ 88.9,p = 0.043)显著低于总体均值。在神经心理评估中,肝脏移植儿童的得分总体低于对照组(p = 0.004),在评估视觉空间和视觉构建功能以及社会感知的子测试中差异显著。在注意力和执行功能、记忆和学习或语言功能的子测试中未发现差异。肝脏移植儿童在视觉空间领域受损的风险增加。

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