Section of Psychology, Psychology Service, Texas Children's Hospital, Baylor College of Medicine, Houston, TX 77030, USA.
J Pediatr Gastroenterol Nutr. 2012 Oct;55(4):384-9. doi: 10.1097/MPG.0b013e318259ed20.
The aim of the present study was to investigate whether male and female infants with biliary atresia (BA) differ cognitively and to confirm previously documented developmental lags in infants with BA before liver transplantation.
With the Mullen Scales of Early Learning, we examined 21 female and 12 male infants (ages 3-20 months) with BA, comparing scores across indices by sex and correlating Mullen Scales of Early Learning scores with standard clinical and biochemical parameters.
Overall, both boys and girls were found to be vulnerable to developmental lags in the areas of expressive language (EL) and gross motor skills. In comparison with their male peers, girls were found to be weaker in the area of visual reception skills (P=0.05) with a trend found for EL (P=0.08). Girls were also found to have higher C-bilirubin levels and to be of shorter length. Growth parameters were found to be correlated with EL scores. International normalized ratio was found to be correlated with gross motor performance and with a trend also noted for fine motor skills. Age at Kasai predicted receptive language skills.
As has been shown, infants with BA appear to be vulnerable to developmental lags before transplantation. In particular, female infants appear to be vulnerable to cognitive and skill delays in comparison with their male peers. C-bilirubin levels may play a role in this increased vulnerability for females.
本研究旨在探讨胆道闭锁(BA)男婴和女婴的认知是否存在差异,并确认肝移植前 BA 患儿先前记录的发育迟缓。
我们使用 Mullen 早期学习量表(Mullen Scales of Early Learning)对 21 名女性和 12 名男性 BA 婴儿(3-20 个月)进行了检查,通过性别比较各指数的评分,并将 Mullen 早期学习量表的评分与标准临床和生化参数相关联。
总体而言,男孩和女孩都被发现容易在表达性语言(EL)和大运动技能方面出现发育迟缓。与男性同龄儿相比,女孩在视觉接受技能方面较弱(P=0.05),EL 方面也有趋势(P=0.08)。女孩的 C-胆红素水平也较高,且身高较短。生长参数与 EL 评分相关。国际标准化比值与大运动表现相关,与精细运动技能也有一定关联。Kasai 手术年龄预测了接受性语言技能。
正如所显示的,BA 婴儿在移植前似乎容易出现发育迟缓。特别是与男性同龄儿相比,女性婴儿似乎更容易出现认知和技能发育迟缓。C-胆红素水平可能在女性的这种易感性增加中发挥作用。