先天性心脏病神经发育结局的研究进展。
Recent advances in our understanding of neurodevelopmental outcomes in congenital heart disease.
机构信息
Division of Pediatric Cardiology, Department of Pediatrics.
Department of Anesthesiology and Critical Care Medicine.
出版信息
Curr Opin Pediatr. 2019 Dec;31(6):783-788. doi: 10.1097/MOP.0000000000000829.
PURPOSE OF REVIEW
Patients with congenital heart disease (CHD) suffer from a pattern of neurodevelopmental abnormalities including deficits in language and executive function. In this review, we summarize recent studies that examine these outcomes, their risk factors, possible biomarkers, and attempts to develop therapeutic interventions.
RECENT FINDINGS
The latest literature has highlighted the role of genetics in determining neurologic prognosis, as we have increased our understanding of potentially modifiable perioperative risk factors. The role of potentially neurotoxic medical therapies has become more salient. One recent focus has been how neurodevelopment affects quality of life and leads to a high prevalence of mental illness. Neuroimaging advances have provided new insights into the pathogenesis of deficits.
SUMMARY
Although many risk factors in CHD are not modifiable, there is promise for interventions to improve neurodevelopmental outcomes in patients with CHD. Biomarkers are needed to better understand the timing and prognosis of injury and to direct therapy. Research into psychosocial interventions is urgently needed to benefit the many survivors with CHD.
目的综述
先天性心脏病（CHD）患者存在神经发育异常模式，包括语言和执行功能缺陷。在这篇综述中，我们总结了最近研究这些结果、其风险因素、可能的生物标志物以及尝试开发治疗干预措施的研究。
最新发现
最新文献强调了遗传学在确定神经预后中的作用，因为我们越来越了解潜在可改变的围手术期风险因素。潜在神经毒性的医学治疗的作用变得更加突出。最近的一个重点是神经发育如何影响生活质量并导致精神疾病的高患病率。神经影像学的进展为理解缺陷的发病机制提供了新的见解。
总结
尽管 CHD 中的许多风险因素是不可改变的，但仍有希望通过干预措施改善 CHD 患者的神经发育结果。需要生物标志物来更好地了解损伤的时间和预后，并指导治疗。迫切需要研究心理社会干预措施，以使许多 CHD 幸存者受益。
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