在患有复杂先天性心脏病的早期青少年中,压力标志物,执行功能和弹性
Lilian von Werdt1,2, Tina M Binz3, Ruth Tuura O'Gorman2,4
1Child Development Center, University Children's Hospital Zurich, Switzerland.
JAMA network open
|February 9, 2024
概括
与健康同龄人相比,患有复杂先天性心脏病 (cCHD) 的青少年表现出更高的生理压力和较低的执行功能 (EF). 这些发现强调了早期手术对神经发育的潜在长期影响.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 神经发育科学 神经发育科学
- 压力生理学 压力生理学
背景情况:
- 患有复杂先天性心脏病 (cCHD) 的婴儿在开放心脏手术期间经历了相当大的压力.
- 长期的压力及其对这些儿童神经发育的影响尚不清楚.
研究的目的:
- 为了比较生理压力标志物 (头发皮质醇/皮质素),执行功能 (EF) 和青少年 (10-15岁) 患有cCHD与健康对照的弹性.
- 在这个人群中调查压力标志物和EF之间的关系.
主要方法:
- 瑞士儿童医院的一项病例对照研究包括100名患有cCHD (婴儿后手术) 的青少年和104名健康对照.
- 通过LC-MS/MS分析皮质醇/皮质的头发样本.
- 神经心理测试评估了EF;一个问卷测量了弹性.
主要成果:
- 与对照组相比,患有cCHD的青少年的皮质醇/皮质水平显著更高,EF得分也比对照组低,即使调整了混因素.
- 两组之间没有观察到自我报告的弹性有显著差异.
- 一个显著的相互作用表明,在cCHD组中,压力标志物和EF之间的负相关性更强.
结论:
- 患有cCHD的青少年表现出改变的生理压力和受损的执行功能.
- 这些发现表明,早期心脏手术,慢性压力和神经发育结果之间存在联系.
- 需要进一步的研究来阐明神经生物学机制和干预的最佳时间.
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