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首页> 外文期刊>Twin research and human genetics : >Anesthesia and cognitive performance in children: no evidence for a causal relationship.
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Anesthesia and cognitive performance in children: no evidence for a causal relationship.

机译：儿童的麻醉和认知能力：无因果关系的证据。

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Recent findings of an association between anesthesia administration in the first three years of life and later learning disabilities have created concerns that anesthesia has neurotoxic effects on synaptogenesis, causing later learning problems. An alternative hypothesis is that those children who are likely to undergo surgery early in life have significant medical problems that are associated with a vulnerability to learning disabilities. These two hypotheses were evaluated in a monozygotic concordant-discordant twin design. Data on anesthesia administration and learning abilities and disabilities were available for 1,143 monozygotic twin pairs (56% female) from the Netherlands Twin Registry. Parents of the twins reported on anesthesia use before age 3 and again between ages 3 and 12 years. Near age 12, educational achievement and cognitive problems were assessed with standardized tests and teacher ratings. Results showed that twins who were exposed to anesthesia before age 3 had significantly lower educational achievement scores and significantly more cognitive problems than twins not exposed to anesthesia. However, there was one important exception: the unexposed co-twin from discordant pairs did not differ from their exposed co-twin. Thus, there is no evidence for a causal relationship between anesthesia administration and later learning-related outcomes in this sample. Rather, there is evidence for early anesthesia being a marker of an individual's vulnerability for later learning problems, regardless of their exposure to anesthesia.
机译：在生命的头三年中服用麻醉药与后来的学习障碍之间的关联的最新发现引起了人们的担忧，即麻醉药对突触发生具有神经毒性作用，从而引起后来的学习问题。另一种假设是，那些可能在生命早期进行手术的孩子患有严重的医学问题，与学习障碍的脆弱性有关。这两个假设在单合子一致-不一致的双胞胎设计中进行了评估。荷兰双胞胎登记处提供了1,143对单卵双胞胎对（56％为女性）的麻醉管理和学习能力与残疾的数据。双胞胎的父母报告在3岁之前以及3至12岁之间再次麻醉。接近12岁时，通过标准化考试和教师评分评估了教育成就和认知问题。结果显示，与未接触麻醉的双胞胎相比，在3岁之前接受麻醉的双胞胎的教育成绩得分明显较低，并且认知问题明显更多。但是，有一个重要的例外：不和谐对中未暴露的双胞胎与未暴露的双胞胎没有区别。因此，在该样本中，没有证据表明麻醉管理与以后的学习相关结果之间存在因果关系。而是，有证据表明，早期麻醉是个体面对以后学习问题的脆弱性的标志，无论他们接受麻醉的程度如何。

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