Department of Psychiatry, University of Pittsburgh Medical Center, PA, USA.
Am J Transplant. 2011 Jun;11(6):1287-95. doi: 10.1111/j.1600-6143.2011.03496.x.
Although it is well known that depression is associated with poorer medical outcomes, the association between depression- and liver transplant (LTX)-specific outcomes has not been investigated. We identified three trajectories of depressive symptoms evolving within the first post-LTX year in a cohort of 167 patients transplanted for alcoholic cirrhosis: a group with consistently low depression levels at all time points (group 1, n = 95), a group with initially low depression levels that rose over time (group 2, n = 41), and a group with consistently high depression levels (group 3, n = 31). Controlling for medical factors associated with poorer survival, recipients with increasing depression or persisting depression were more than twice as likely to die (all cause mortality) within the subsequent years. At 10 years post-LTX the survival rate was 66% for the low depression group, but only 46% and 43%, respectively, for the increasing depression and high depression groups. Except for a paradoxically higher percentage of malignancies in the low depression group, the causes of death and other specific LTX outcomes were not different between groups. Whether treatment of depression will improve survival rates is an area for research.
尽管众所周知，抑郁症与较差的医疗结果相关，但抑郁症与肝移植（LTX）特定结果之间的关联尚未得到研究。我们在一个接受酒精性肝硬化移植的 167 名患者队列中，在 LTX 后的第一年中确定了三种抑郁症状演变轨迹：一组在所有时间点都保持低抑郁水平（第 1 组，n=95），一组最初低抑郁水平随着时间的推移而升高（第 2 组，n=41），一组持续高抑郁水平（第 3 组，n=31）。在控制与较差生存相关的医疗因素后，抑郁程度增加或持续存在的患者在随后几年内死亡（全因死亡率）的可能性是两倍多。在 LTX 后 10 年，低抑郁组的生存率为 66%，而抑郁程度增加组和高抑郁组分别为 46%和 43%。除了低抑郁组中恶性肿瘤的比例高得令人费解外，各组之间的死亡原因和其他特定的 LTX 结果并无不同。治疗抑郁症是否会提高生存率是一个研究领域。
