法洛四联症婴幼儿神经心理发育的影响因素  

Influence factors for neurodevelopmental impairment of infants with tetralogy of Fallot

作　　者：吴珍[1] 王晓航[1] 莫绪明[2] 李晓南[3] 赵卫华[3] 陈银花[3] 

机构地区：[1]南京大学医学院,210093 [2]南京医科大学附属南京儿童医院心胸外科 [3]南京医科大学附属南京儿童医院儿保科

出　　处：《中华胸心血管外科杂志》2012年第9期533-535,539,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：南京市科技发展人口健康项目（201104012）;世界健康基金会“上海儿童医学中心一雅培/世界健康基金会临床营养发展中心（AFINS）项目（AFINS-HOPE-2011-11-B）

摘　　要：目的分析婴幼儿法洛四联症（TOF）神经心理发育的影响因素。方法应用《贝利婴幼儿发展量表》（BSID）评估2010年10月至2011年10月收治的83例0～3岁法洛四联症患儿神经心理发育，将患儿分为正常和异常两组。男55例，女28例，智力发展指数（MDI）和精神运动发展指数（PDI）在男女组间差异无统计学意义（P〈0．05）。比较患儿出生体质量、手术年龄、手术体质量、术前经皮血氧饱和度（SPO2）、术前红细胞压积（HCT）、McGoon指数、左心室舒张期末容积指数（LVEDI）的组间差异。行单因素多重线性回归模型进行分析，将单因素分析有意义的变量纳入多因素多重线性回归模型。结果MDI正常（≥80分）67例（80．7％），异常（〈80分）16例（19．3％），t检验示两组间McGoon指数、LVEDI、出生体质量差异有统计学意义。多元线性回归分析示McGoon指数、LVEDI和手术术龄是影响婴幼儿法洛四联症智力发展指数的主要因素，偏回归系数分别为21．41，0．59，-0．31（P〈0．05），其中手术年龄为负相关，McGoon指数对智力发展指数影响最大。PDI正常（≥80分）61例（73．5％），异常22例（26．5％），两组间t检验示McGoon指数和LVEDI差异有统计学意义。多元线性回归分析示McGoon指数和LVEDI是影响法洛四联症患儿精神运动发展指数的主要因素，偏回归系数分别是23．88，0．49（P=0．000），McGoon指数影响较大。结论McGoon指数、左心室舒张末容积指数和手术术龄是影响婴幼儿法洛四联症智力发展指数的危险因素。McGoon指数和左心室舒张末容积指数是影响法洛四联症婴幼儿精神运动发展指数的危险因素。McGoon指数对法洛四联症婴幼儿神经心理发育的影响最大。Objective To analyze the risk factors for neurodevelopmental impairment of infants with tetralogy of Fallot （ TOF）. Methods Neurodevelopment of infants aged 0-3 years and undergoiong tetralogy of Fallot surgic operations in NanJing Children Hospital between October 2010 and October 2011 were assessed with Bayley Scales of Infant Development test （BSID）. On the basis of assessment results, infants with 90 piont or more were devided into the normal group,and the rest less than 90 point were devided into the abnormal group. Compare the difference of birb weight, age, weight transcutaneous oxygen saturation （SPO2 ） , hematokrit （HCT） , McGoon index and left ventricular end-diastolic capacity index（ LVEDI ） at surgery between the two groups with t-test. And to identify risk factors for neurodevelopmental impairment of infants with tetralogy of Fallot with multivariate linear regression analysis. P 〈 O. 05 was statistically significant. Results All of 83 infants with 55 males and 28 females were admitted into this prospective study. There was no statistical significance in mental development in- dex （MDI） and psychological development index （PDI） between the sexes. For MDI： normal 67 （80.7%）, abnormal 16 （ 18.3% ）. With t-test, McGoon index, left ventricular end-diastolic capacity index and birth weight had significant difference between the two groups （P 〈 O. 05 ）. Multivariate linear regression analysis showed that MeGoon index, left ventricular end-di- astolic capacity index and age at surgry were risk factors for MDI decrease, beta was 21.41, 0- 59 and -0.31, respectively （P〈 0.05）. Age at surgry was connected with MDI nagetively, McGoon index affected mostly. For PDI： normal 61 （73.5%） , abnormal 22（26.5% ）. With t-test, MaGoon index and left ventrieular end-diastolic capacity index had statistical significance between the two groups （P 〈 0. 05 ）. Multivariate linear regression analysis showed that McGoon index and left ven- tricular end-diastolic

关 键 词：法洛四联症 贝利发展量表 神经心理 婴幼儿 

分 类 号：R726.5[医药卫生—儿科]