Bender B G, Belleau L, Fukuhara J T, Mrazek D A, Strunk R C
Pediatrics. 1987 May;79(5):723-7.
Acute effects of steroid medications or hypoxic-induced brain damage have been hypothesized to cause neuropsychologic impairment in children with severe asthma. The present investigation included neuromotor, cognitive, psychosocial, and medical evaluations of 67 hospitalized asthmatic children from 9 to 14 years of age, at risk for motor dysfunction. Mean scores from the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) were similar to test norm means and were not indicative of neuromotor impairment. Scores of the BOTMP correlated significantly (P less than .01) with measures of child and family psychosocial adaptation but not with measures of cognitive ability, steroid dose at admission, or severity of asthma. Thirteen children had battery composite scores more than 1 SD below age means but did not demonstrate decreased IQ or increased steroid use, respiratory failure, seizures, or abnormal neurologic signs compared with the other 55 children. These results indicate that most severely asthmatic children, including many with histories of hypoxia and high-dose steroid use, do not demonstrate psychomotor impairments indicative of brain damage. It is concluded that neuromotor development in asthmatic children is associated with psychologic characteristics that influence adaptation to illness and activity level.
类固醇药物的急性效应或缺氧引起的脑损伤被认为会导致重度哮喘儿童出现神经心理损害。本研究对67名9至14岁的住院哮喘儿童进行了神经运动、认知、心理社会和医学评估，这些儿童存在运动功能障碍风险。布鲁宁克斯-奥塞雷茨基运动能力测试（BOTMP）的平均得分与测试常模均值相似，并不表明存在神经运动损害。BOTMP得分与儿童及家庭心理社会适应指标显著相关（P小于0.01），但与认知能力指标、入院时的类固醇剂量或哮喘严重程度无关。13名儿童的综合测试得分比年龄均值低1个标准差以上，但与其他55名儿童相比，其智商并未降低，类固醇使用量、呼吸衰竭、癫痫发作或神经学体征也未增加。这些结果表明，大多数重度哮喘儿童，包括许多有缺氧和高剂量类固醇使用史的儿童，并未表现出表明脑损伤的精神运动损害。研究得出结论，哮喘儿童的神经运动发育与影响疾病适应和活动水平的心理特征有关。
