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移植后认知功能的变化:一个纵向队列研究

Aditi Gupta1, Jonathan D Mahnken2, Joshua Bernal3

  • 1Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas; Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas; University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, Kansas; Frontiers Clinical and Translational Science Institute, University of Kansas Medical Center, Kansas City, Kansas.

American journal of kidney diseases : the official journal of the National Kidney Foundation
|February 29, 2024
PubMed
概括

移植 (KT) 显著改善认知功能,特别是情节性记忆,这使术后正常化. 其他认知领域显示部分恢复,表明与脏疾病相关的认知障碍在很大程度上是可逆的.

关键词:
移植, 认知障碍, ESKD

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科学领域:

  • 腎臟病學 (nephrology) 是一種醫學.
  • 神经心理学 神经心理学
  • 移植医学 移植医学

背景情况:

  • 众所周知,病会在各个领域损害认知功能.
  • 移植 (KT) 对认知领域的影响尚未完全理解.
  • 了解KT后的认知变化对于患者的护理和生活质量至关重要.

研究的目的:

  • 评估移植 (KT) 对不同认知领域的影响.
  • 为了确定KT后的认知改善是否在所有认知功能中均.
  • 评估与脏疾病相关的认知障碍的可逆性.

主要方法:

  • 一项前性队列研究,涉及在学术中心等待KT的候选名单上的患者.
  • 使用标准的神经心理测试测量认知功能在KT前,在KT后3个月和1年.
  • 线性混合模型分析被用来评估认知得分的变化,调整为人口因素.

主要成果:

  • 情节性和口头声明性记忆 (逻辑记忆I和II) 在KT后显著改善,正常化到与规范数据相似的水平.
  • 语义记忆,口语流 (类别流) 和精神运动速度/视觉空间功能 (DSST) 也在KT后显著改善,尽管DSST得分仍然低于规范值.
  • 全球认知 (MMSE),工作记忆/注意力 (Digit Span) 和执行功能 (TMT A和B) 在KT后没有显著变化.

结论:

  • 腎臟移植導致插曲性和口頭宣言性記憶的正常化.
  • 在KT后的语义记忆,口语流以及心理运动速度/视觉空间功能方面,观察到显著但部分的改善.
  • 与病相关的认知障碍在移植后至少部分可逆.