影响因素及异常发育Influencingfactors

影响因素及异常发育Influencingfactorsandabnormaldevelopment目录-CONTENTS影响认知功能发育的因素Factorsaffectingthedevelopmentofcognitivefunction01异常发育Abnormaldevelopment02影响认知功能发育的因素FactorsaffectingthedevelopmentofcognitivefunctionPARTONE1.遗传因素Geneticfactors

染色体畸变，如21-三体综合征、18-三体综合征，都伴有认知功能障碍及智能障碍。多种单基因遗传病包括先天性代谢病，都影响神经发育，伴有精神发育迟滞，肌张力改变以及运动障碍。Chromosomalaberrations,suchastrisomy21andtrisomy18,areassociatedwithcognitiveimpairmentandintellectualimpairment.Avarietyofsinglegenegeneticdiseases,includingcongenitalmetabolicdiseases,affectnervedevelopment,accompaniedbymentalretardation,muscletonechangesanddyskinesia.2.妊娠期和围生期危险因素Riskfactorsinpregnancyandperinatalperiod

（1）妊娠期危险因素：感染、药物、辐射、污染等。妇女患严重慢性疾病。

Infection,medicine,radiation,pollution,etc.Womensufferfromseriouschronicdiseases.（2）围生期危险因素：早产、分娩过程中脐带绕颈、胎盘前置、胎盘早剥、胎粪吸入等导致胎儿脑部缺氧，难产或过期胎儿产程过长，产钳损伤和颅脑出血、新生儿核黄疸，以及出生后严重的中毒、感染、缺氧、外伤等，使脑组织受到直接或间接的损伤。Prematuredelivery,umbilicalcordaroundtheneckduringdelivery,placentaprevia,placentalabruption,meconiuminhalationleadtofetalbrainhypoxia,dystociaorprolongedfetallabor,forcepsinjuryandcraniocerebralhemorrhage,neonatalnuclearjaundice,aswellasseriouspostnatalpoisoning,infection,hypoxia,trauma,etc.,whichdirectlyorindirectlydamagebraintissue.3.营养因素Nutritionalfactors

在神经细胞的发育阶段，有赖于各种营养素为其提供充足的能量和材料。包括碳水化合物、蛋白质、氨基酸、微量元素等。这些营养素促进神经系统的发育及构成。Inthedevelopmentstageofnervecells,itdependsonavarietyofnutrientstoprovidesufficientenergyandmaterials.Itincludescarbohydrate,protein,aminoacid,traceelementandsoon.Thesenutrientspromotethedevelopmentandcompositionofthenervoussystem.4.慢性疾病chronicdisease

内分泌疾病，如甲状腺功能减退症对生长发育的影响更为突出（呆小症）。长期慢性疾病有些可使儿童产生不适、疼痛，有些影响会限制儿童的日常活动和社会交往，有些会使儿童感到恐惧和焦虑、自卑等。Endocrinediseases,suchashypothyroidism,haveamoreprominenteffectongrowthanddevelopment.Somechronicdiseasesmaycausechildrendiscomfortandpain,somemayrestrictchildren'sdailyactivitiesandsocialinteraction,andsomemaymakechildrenfeelfear,anxietyandinferiority.5.家庭环境因素Familyenvironmentfactors

（1）经济状况：家庭社会经济状况较好的家庭，小儿的语言、适用能力和智力的发育均优于社会经济状况较差的家庭。Thedevelopmentofchildren'slanguage,applicationabilityandintelligenceinthefamilywithgoodsocialandeconomicstatusisbetterthanthatinthefamilywithpoorsocialandeconomicstatus.

（2）父母的文化程度和职业：父母不仅通过自身的文化素质对子女产生潜移默化的作用，还通过对子女教育的形式与投资产生影响。Parentsnotonlyhaveasubtleeffectontheirchildrenthroughtheirownculturalquality,butalsohaveanimpactontheformandinvestmentoftheirchildren'seducation.

（3）父母对子女的态度：父母对子女的过分溺爱、过分担心和过分保护，以及歧视或对子女有不切实际的过分期望等均对儿童行为有影响。Parents'overindulgence,overworryandoverprotectionoftheirchildren,discriminationorunrealisticexpectationsontheirchildrenallhaveanimpactonchildren'sbehavior.6.社会环境socialenvironment

良好的居住环境和卫生条件有利于儿童认知发育，反之则带来不利影响。Goodlivingenvironmentandhealthconditionsareconducivetochildren'scognitivedevelopment,otherwiseitwillbringadverseeffectsAbnormaldevelopment异常发育PARTTWO1.地方性克汀病Endemiccretinism

又称地方性呆小病，发生在地方性甲状腺肿流行区。由该病所导致的精神发育迟滞、智力低下的程度比较严重。临床表现大多以安静、迟钝、萎靡、活动上少见者为常见，少部分性情暴躁、哭笑无常。体格发育迟缓、发育不良是本病的另一特征。胎儿期缺碘和碘缺乏，碘摄入每天小于20u则会有地方性克汀病出现。为此，应提倡病区育龄妇女注射或口服碘油，同时对新生儿进行微量脐血T3、T4、TSH检测，以早发现、早诊断、早治疗。Itisalsocalledendemicgoiter,whichoccursinendemicgoiterepidemicarea.Thementalretardationandmentalretardationcausedbythediseaseareserious.Mostoftheclinicalmanifestationswerequiet,dull,dispirited,andrarelyseeninactivities.Afewofthemwereirritable,cryingandlaughing.Physicalretardationanddysplasiaareanothercharacteristicofthedisease.Iftheiodineintakeislessthan20uperday,endemiccretinismwillappear.Therefore,itissuggestedthatwomenofchildbearingageinthewardshouldbegivenlipiodolbyinjectionororaladministration,andatthesametime,asmallamountofT3,T4andTSHincordbloodofnewbornsshouldbedetectedforearlydetection,earlydiagnosisandearlytreatment.1.地方性克汀病Endemiccretinism2.苯丙酮尿症Phenylketonuria

这是一种氨基酸代谢病，是遗传缺陷所致精神发育迟滞较常见的类型。由于先天缺乏苯丙氨酸羟化酶，体内苯丙氨酸不能转化成酪氨酸而引起一系列代谢紊乱。临床表现主要以智力缺损，而且一般损害严重。但出生时往往正常，在出生数月后即见患儿发育迟缓，烦躁，、易激惹、易兴奋、反应迟钝，有明显的语言障碍。神经体征见震颤、张力异常、共济失调、腱反射亢进甚至瘫痪，可伴有癫痫。Thisisakindofaminoacidmetabolicdisease,whichisacommontypeofmentalretardationcausedbygeneticdefects.Duetothecongenitallackofphenylalaninehydroxylase,phenylalaninecannotbeconvertedintotyrosineinthebody,resultinginaseriesofmetabolicdisorders.Themainclinicalmanifestationismentalimpairment,andthedamageisgenerallyserious.However,itisnormalatbirth.Afterafewmonthsofbirth,thechildisfoundtohavedevelopmentalretardation,irritability,irritability,excitability,slowresponseandobviouslanguagedisorder.Nervoussignsincludetremor,dystonia,ataxia,hyperreflexiaandevenparalysis,whichmaybeaccompaniedbyepilepsy.2.苯丙酮尿症Phenylketonuria

本病若能在出生后短期内及时发现，及早予以饮食控制或给予低苯丙氨酸蛋白，智力发育可望正常。早期诊断：新生儿出生48小时后，取足跟血滴于滤纸上。Ifthediseasecanbefoundinashorttimeafterbirth,anddietcontrolorlowphenylalanineproteinisgivenassoonaspossible,theintelligencedevelopmentwillbenorma