Nihal Dündar, Bumin Dündar, Bumin Dündar, Faruk Öktem, Faruk Öktem

Doğumsal kalp hastalıkları ve büyüme geriliği

Süleyman Demirel Üniversitesi TIP FAKÜLTESİ DERGİSİ: 2007 Aralık; 14(4) Doğumsal kalp hastalıkları ve büyüme geriliği *Nihal Dündar, **Bumin Dündar, ***Faruk Öktem *Gülkent Devlet Hastanesi, Çocuk Sağlığı ve Hastalıkları **Süleyman Demirel Üniversitesi Tıp Fakültesi, Pediatrik Endokrinoloji Bilim Dalı ***Süleyman Demirel Üniversitesi Tıp Fakültesi, Pediatrik Nefroloji Bilim Dalı Özet Büyüme geriliği doğumsal kalp hastalıklarının (DKH) iyi bilinen bir komplikasyonu olup, hala DKH.lı çocuklarda önemli bir problem olmaya devam etmektedir. Bu hastalardaki büyüme geriliği, düzeltme ameliyatlarında gecikmeye ve ameliyat sonrası morbiditede risk artışına neden olmaktadır. Bu tür hastalarda, yetersiz kalori alımı, artmış enerji ihtiyacı, malabsorbsiyon, hastalık şiddeti ve hipoksi büyüme yetersizliğinde en önemli büyüme geriliği nedenleridir. Bununla birlikte yetersiz büyümeyle ilgili mekanizmalar hala tartışmalıdır. Son zamanlarda endokrin faktörler üzerinde durulmuş ve siyanotik ve asiyanotik DKH.da büyüme geriliği ile ilişkili düşük insülin benzeri büyüme faktörü-1 düzeyleri bildirilmiştir. Bu derlemede, DKH.lı çocuklardaki büyüme geriliğinin sıklığı, mekanizmaları ve bu olguların büyümelerini iyileştirmedeki yenilikler tartışılmıştır. Anahtar kelimeler: doğumsal kalp hastalığı, büyüme geriliği, Abstract Congenital Heart Diseases and Growth Failure Growth failure is a well-recognized complication of congenital heart disease (CHD) and still an important problem for children with CHD. Growth failure in these children cause delay in surgical correction and increased risk of morbidity postoperatively. Inadequate caloric intake, increased energy requirements, malabsorption, severity of disease and hypoxia appears to be the most important factors in growth failure of CHD. However, underlying mechanisms of growth failure is still controversial. The role of endocrine factors has been evaluated recently and low serum insulin like growth factor-1 levels associated with growth delay have been reported in both cyanotic and acyanotic CHD. In the following rewiew, incidence, mechanisms of growth failure and recent methods of improving growth and catch-up growth in children with CHD are discussed. Key words: congenital heart disease, growth failure

Anahtar Kelimeler:

doðumsal kalp hastalýðý, büyüme geriliði

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