Yilmaz İlksen Z, Erdur Baris, Ozbek Erhan, Mese Timur, Karaarslan Utku, Genel Ferah
Department of Pediatrics, Dr. Behcet Uz Children's Hospital, Izmir, Turkey.
Department of Pediatrics, Dr. Behcet Uz Children's Hospital, Izmir, Turkey -
Minerva Pediatr. 2018 Aug;70(4):365-370. doi: 10.23736/S0026-4946.17.04265-7. Epub 2015 Jun 4.
The aim of the study was to perform a neurodevelopmental evaluation of the children with cyanotic congenital heart disease and to determine the factors that affect the neurodevelopmental status.
The study was performed in the Pediatric Cardiology Department of Behcet Uz Children's Hospital between February and August 2013. Children between the age of six to forty-two months were included in the study and were evaluated in three groups (two patient groups and the control group). In group A, patients with isolated cyanotic congenital heart disease were enrolled. Group B consisted of the patients with cyanotic congenital heart disease with other concomitant diseases. Group C included the healthy control group. For the neurodevelopmental evaluation Bayley Scale of Infant Development- II (BSID-II) was used. Mental Developmental Index (MDI) and Psychmotor Developmental Index (PDI) scores were calculated. Factors possibly effective on neurodevelopment were evaluated.
Thirty eight patients (32 in group A and 6 in group B) and 33 healthy subjects in group C were included in the study. Mean age of the patient group was 22.5±11.2 months. In group A mean MDI Score (82.5±14.7) was significantly lower than group C (92.3±6.9) (P=0.001). Similarly mean PDI Score in group A (82.0±18.2) was found significantly lower than group C (92.5±7.4) (P=0.003). When group A and B were compared, mean MDI and PDI scores were lower in group B, but the difference was not statistically significant. For group A, according to the psychomotor development index, 41.6% of the patients were found to be mildly to severely retarded. In terms of the mental development index, 34.4% of the patients had moderate or mild retardation. The sex, socioeconomic status, gestational age, birth weight, comorbidities, history of surgery and reoperation, length of stay in intensive care unit were not found influential on the MDI and PDI scores of the patients.
Mental-motor retardation is frequently encountered in children with cyanotic congenital heart disease. These patients may benefit from motor, language, speech, developmental and educational therapies. For this reason, these children have to be under regular follow up for neurodevelopmental status.
本研究旨在对患有青紫型先天性心脏病的儿童进行神经发育评估，并确定影响神经发育状况的因素。
本研究于2013年2月至8月在贝赫切特·乌兹儿童医院儿科心脏病科进行。年龄在6至42个月之间的儿童被纳入研究，并分为三组（两个患者组和一个对照组）。A组纳入单纯性青紫型先天性心脏病患者。B组由患有青紫型先天性心脏病并伴有其他疾病的患者组成。C组为健康对照组。神经发育评估采用贝利婴幼儿发展量表第二版（BSID-II）。计算心理发育指数（MDI）和心理运动发育指数（PDI）得分。评估可能对神经发育有影响的因素。
本研究纳入了38例患者（A组32例，B组6例）和C组33例健康受试者。患者组的平均年龄为22.5±11.2个月。A组的平均MDI得分（82.5±14.7）显著低于C组（92.3±6.9）（P=0.001）。同样，A组的平均PDI得分（82.0±18.2）显著低于C组（92.5±7.4）（P=0.003）。比较A组和B组时，B组的平均MDI和PDI得分较低，但差异无统计学意义。对于A组，根据心理运动发育指数，41.6%的患者被发现有轻度至重度发育迟缓。就心理发育指数而言，34.4%的患者有中度或轻度发育迟缓。未发现性别、社会经济状况、胎龄、出生体重、合并症、手术和再次手术史、重症监护病房住院时间对患者的MDI和PDI得分有影响。
青紫型先天性心脏病患儿经常出现精神运动发育迟缓。这些患者可能从运动、语言、言语、发育和教育治疗中受益。因此，必须对这些儿童的神经发育状况进行定期随访。
