Holm Sara Krøis, Vestergaard Martin, Madsen Kathrine Skak, Baaré William F C, Hammer Trine Bjørg, Born Alfred Peter, Siebner Hartwig R, Paulson Olaf B, Uldall Peter V
Department of Pediatrics and Adolescent Medicine, Neuropediatric Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark.
Acta Paediatr. 2015 Aug;104(8):784-91. doi: 10.1111/apa.13010. Epub 2015 Apr 23.
Perinatal exposure to glucocorticoids has been associated with adverse cerebral effects, but little is known about their effect on cognitive development and exposure later in childhood. This study examined intellectual abilities, memory and behavioural problems in children previously treated with glucocorticoids.
We evaluated 38 children aged from seven to 16 years, who had been treated with glucocorticoids for rheumatic disease or nephrotic syndrome, together with 42 healthy controls matched for age, gender and parental education. The median cumulative dose of prednisolone equivalents was 158 mg/kg (range 21-723) and the mean time that had elapsed since treatment was three-and-a-half (standard deviation 2.2) years. Intellectual abilities were assessed with the Wechsler Intelligence Scale for Children and memory performance and behavioural problems with a pattern recognition memory task and the Child Behaviour Check List.
There were no significant differences between the groups in pattern recognition memory, perceptual organisation index or behavioural problems, but patients had a significantly lower verbal comprehension index and this difference was present in both disease groups. There were no significant dose-response relationships regarding verbal intellectual abilities.
Children and adolescents previously treated with glucocorticoids seemed to have lower intellectual verbal abilities than healthy controls.
围产期暴露于糖皮质激素已被证明与不良脑效应有关,但对于其对认知发育以及儿童期后期暴露的影响知之甚少。本研究调查了曾接受糖皮质激素治疗的儿童的智力、记忆和行为问题。
我们评估了38名7至16岁因风湿性疾病或肾病综合征接受过糖皮质激素治疗的儿童,以及42名在年龄、性别和父母教育程度方面与之匹配的健康对照。泼尼松龙等效物的累积剂量中位数为158mg/kg(范围21 - 723),自治疗结束后的平均时间为三年半(标准差2.2)。使用韦氏儿童智力量表评估智力,通过模式识别记忆任务和儿童行为检查表评估记忆表现和行为问题。
两组在模式识别记忆、知觉组织指数或行为问题方面无显著差异,但患者的言语理解指数显著较低,且在两个疾病组中均存在这种差异。在言语智力能力方面不存在显著的剂量 - 反应关系。
曾接受糖皮质激素治疗的儿童和青少年的言语智力能力似乎低于健康对照。