Newburger J W, Silbert A R, Buckley L P, Fyler D C
N Engl J Med. 1984 Jun 7;310(23):1495-9. doi: 10.1056/NEJM198406073102303.
To assess the effect of the duration of chronic hypoxemia on cognitive function, we studied 38 children with d-transposition of the great arteries and an intact ventricular septum who underwent corrective surgery at six months to six years of age (median, 1.6 years). Tests included the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) in 33 children and the visual-association and auditory-association subtests of the Illinois Test of Psycholinguistic Abilities in 38 and 37 children, respectively. When controlled for social index, age at repair was inversely associated with the WPPSI intelligence-quotient score (P less than 0.01), the visual-association subtest score (P less than 0.01), and the auditory-association subtest score (P less than 0.1). In contrast, age at repair correlated poorly with cognitive function in children with ventricular septal defect, an acyanotic congenital heart defect. These data suggest that postponing repair of a cyanotic congenital heart disease, such as transposition of the great arteries, is associated with progressive impairment of cognitive function.
为评估慢性低氧血症持续时间对认知功能的影响，我们研究了38例大动脉d型转位且室间隔完整的儿童，这些儿童在6个月至6岁（中位数为1.6岁）时接受了矫正手术。测试包括分别对33例儿童进行韦氏学前及初小儿童智力测验（WPPSI），以及对38例和37例儿童分别进行伊利诺伊心理语言能力测验的视觉联想和听觉联想子测验。在对社会指数进行控制后，修复时的年龄与WPPSI智商得分（P<0.01）、视觉联想子测验得分（P<0.01）及听觉联想子测验得分（P<0.1）呈负相关。相比之下，对于室间隔缺损（一种无青紫型先天性心脏病）患儿，修复时的年龄与认知功能的相关性较差。这些数据表明，推迟诸如大动脉转位等青紫型先天性心脏病的修复与认知功能的渐进性损害有关。
