肝移植接受者的认知障碍的发生率
Kacey Berry1, Jessica M Ruck2, Fawzy Barry3
1Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA.
Clinical transplantation
|December 19, 2023
概括
认知障碍 (CI) 在肝移植 (LT) 接受者中在LT之前和之后是常见的.LT前的认知功能显著预测LT后的CI,强调需要在LT候选人中进行更好的神经学评估.
科学领域:
- 神经学 神经学
- 肝病学 肝病学是一种肝病学.
- 移植医学 移植医学
背景情况:
- 肝移植 (LT) 接受者面临许多认知障碍风险因素.
- 总部位于美国的LT接受者的认知能力仍未得到充分研究.
- 肝硬化会影响认知功能,即使没有明显的肝脑病变 (HE).
研究的目的:
- 确定LT接受者在LT前后认知障碍 (CI) 的患病率.
- 为了确定后LT认知障碍的预测因素.
- 评估CI在长时间后持续存在的情况.
主要方法:
- 对107名成年LT接受者进行前性研究,他们患有肝硬化,但没有活跃的前LT HE.
- 使用蒙特利尔认知评估 (MoCA;CI定义为MoCA<24) 评估的认知功能在LT前和LT后≥3个月.
- 后勤回归用于分析认知表现和受体特征之间的关联.
主要成果:
- 36%的接受者在LT前有CI,27%的接受者在LT后有CI≥3个月 (中位数MoCA26).
- 在LT前的MoCA得分每增加1个点,就会使LT后CI的几率降低26% (aOR 0.74).
- 在LT后,CI仍然普遍存在,这表明除了门高血压之外的因素有所贡献.
结论:
- 认知障碍是LT接受者的一个重要问题,在移植后持续很长时间.
- 前LT认知状态是后LT认知结果的强有力的预测因素.
- 迫切需要对LT候选人和接受者进行全面的神经评估,以解决认知缺陷.
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