在接受肝移植的酒精相关肝病患者的认知表现
Magdalena Grusiecka-Stańczyk1, Maciej K Janik1, Piotr Olejnik2
1Department of Hepatology, Transplantology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
概括
认知障碍在与酒精有关的肝硬化 (ALD) 患者中很常见. 肝移植 (LT) 可以改善认知能力,但缺陷往往持续存在,这凸显了对干预的需要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 神经心理学 神经心理学
- 移植医学 移植医学
背景情况:
- 与酒精有关的肝硬化 (ALD) 中的认知障碍 (CI) 经常被低估,并且通常仅归因于肝脑病变 (HE).
- 即使在肝移植 (LT) 后,CI也可能持续存在,这表明除了急性HE之外还有复杂的潜在机制.
- 评估和理解LT前后的认知功能对于管理ALD患者至关重要.
研究的目的:
- 评估ALD患者在LT前后的认知障碍的患病率和性质.
- 确定LT对这一群体认知功能的影响.
- 识别特定的认知领域,改善或继续受损后LT.
主要方法:
- 一组101名等待LT的ALD患者使用阿登布鲁克的认知检查III (ACE III) 进行了评估.
- 其中,61名患者接受了LT,55名患者被纳入纵向评估 (LT后7.1个月).
- 进行了结构化精神病学评估,以评估移植前和移植后的认知状态.
主要成果:
- 在临床试验前,86%的患者得分低于ACE III CI值,其中33%的患者有轻度CI,52%的患者患有痴呆症的可能性很高.
- 在LT后,观察到ACE III总体得分的显著改善 (Δ +7.07,P < 0.01),特别是在记忆和口头流利方面.
- 尽管情况有所改善,但在执行功能和流性方面仍存在持续的缺陷,这表明认知恢复不完全.
结论:
- 肝移植导致与酒精有关的肝硬化患者的认知能力显著改善.
- 然而,ALD的认知障碍在LT后并非完全可逆,执行功能和流性仍然受到影响.
- 在LT前后进行有针对性的认知干预是必要的,以解决ALD患者的持续缺陷.
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