Changes in neurocognitive functioning following lung transplantation.
Changes in neurocognitive functioning following lung transplantation.
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DOI：
10.1111/j.1600-6143.2012.04072.x
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发表时间：
2012-09
期刊：
影响因子：
--
通讯作者：
Palmer S
中科院分区：
文献类型：
--
作者：
Hoffman BM;Blumenthal JA;Carney RC;O'Hayer CV;Freedland K;Smith PJ;Babyak MA;Davis RD;Mathew JP;Martinu T;Palmer S
虽然神经认知障碍在晚期肺部疾病患者中相对常见，但对肺移植后神经认知的变化知之甚少。因此，我们在肺移植前和移植后6个月进行了10次神经认知功能测试，试图确定变化的预测因素。在49名研究参与者中，原生疾病包括COPD （n = 22）、囊性纤维化（n = 12）、非纤维化疾病（n = 11）和其他（n = 4）。尽管肺移植前后执行功能和言语记忆评分的综合测量值通常在正常范围内，但移植后的言语记忆表现略好于基线（p < 0.0001）。年轻患者的执行功能评分改善，而老年患者的执行功能评分恶化（p = .03）。少数患者（29%）从基线到移植后表现出显著的认知能力下降（即至少20%的测试出现bb0.1标准差）。下降的患者年龄较大（p < 0.004），受教育程度较低（p = 0.07）。肺移植与心脏血管重建手术一样，似乎与一部分老年患者的认知能力下降有关，这可能影响移植后的日常功能。
Although neurocognitive impairment is relatively common among patients with advanced lung disease, little is known regarding changes in neurocognition following lung transplantation. We therefore administered ten tests of neurocognitive functioning before and 6-months following lung transplantation and sought to identify predictors of change. Among the 49 study participants, native diseases included COPD (n = 22), cystic fibrosis (n = 12), non-fibrotic diseases (n = 11) and other (n = 4). Although composite measures of executive function and verbal memory scores were generally within normal limits both before and after lung transplantation, verbal memory performance was slightly better posttransplant compared to baseline (p < .0001). Executive function scores improved in younger patients but worsened in older patients (p = .03). A minority subset of patients (29%) exhibited significant cognitive decline (i.e., > 1 standard deviations on at least 20% of tests) from baseline to post-transplant. Patients who declined were older (p < .004) and tended to be less educated (p = .07). Lung transplantation, like cardiac revascularization procedures, appears to be associated with cognitive decline in a subset of older patients, which could impact daily functioning post-transplant.
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