婴幼儿先天性心脏病合并认知及运动功能障碍的临床研究

Clinical study of cognitive and motor function impairment in infants with congenital heart disease

目的了解不同类型先天性心脏病（congenital heart disease,CHD）婴幼儿的认知及运动功能情况。方法收集我院2009年1月至2014年2月收治的CHD术前患儿164例资料,根据有无青紫分为青紫组（n=31）和非青紫组（n=133）;又根据畸形复杂程度分为单纯型组（n=103）和复杂型组（n=61）。选取同期本科儿保门诊年龄3~30个月健康婴幼儿110例为对照组。由本科评估师在术前以贝利婴幼儿发展量表评估认知及运动功能情况并进行比较分析。结果青紫组与非青紫组患儿智力发展指数（mental development index,MDI）及运动发展指数（psychomotor Development Index,PDI）均低于健康婴幼儿（P〈0.01）,且青紫组低于非青紫组（P〈0.01）;单纯型组与复杂型组患儿MDI及PDI均低于健康婴幼儿（P〈0.01）,且复杂型组低于单纯型组（P〈0.05）。结论 CHD患儿3岁前即出现认知功能及运动障碍,障碍程度高于健康婴幼儿,其中青紫型CHD高于非青紫型,复杂型CHD高于单纯型。

Objective To study the cognitive and motor function impairment in infants with different types of congenital heart disease （CHD）. Methods Totally, 164 infants with CHD were collected from our hospital during January 2009 to February 2014, and divided into a cyanosis group （n = 31 ） and a non- cyanosis group （ n = 133 ） according to the presence or absence of cyanosis, and meanwhile, divided into the simple group （ n = 103 ） and the complex group （ n = 61 ） according to the heart malformation degree. At the same time, 1 l0 health neonates were selected as the control group. The cognitive and motor functions were assessed by Bayley scales of infant development （BSID）. Results The mental development index （MDI） and psychomotor development index （PDI） of the infants with CHD were lower than those of the health neonates （ P 〈 0. 01 ）. The MDI and PDI were lower in the cyanosis group than in the non-cyanosis group （P 〈 0. 01 ） , and lower in the complex group than in the simple group （ P 〈 0. 05 ）. Conclusion The incidence of cognitive and motor function impairment appears in the infants with CHD before three years-old, and the infants with cvanosis and complex type show relatively high impairment degree.