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肾移植术后的神经系统并发症:一项回顾性临床研究。

Neurological Complications after Renal Transplantation: A Retrospective Clinical Study.

作者信息

Cengiz Nilgün, Adibelli Zelal, Yakupoğlu Yarkın Kamil, Türker Hande

机构信息

Department of Neurology, Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey.

Department of Nephrology, Atatürk State Hospital, Antalya, Turkey.

出版信息

Noro Psikiyatr Ars. 2015 Dec;52(4):331-335. doi: 10.5152/npa.2015.9876. Epub 2015 Dec 1.

Abstract

INTRODUCTION

The aim of this study was to evaluate the incidence and types of neurological complications (NCs) and associated factors in renal transplantation (RT) patients.

METHODS

Three hundred and forty-four patients who had RT performed at our institution between January 2005 and July 2014 were retrospectively evaluated.

RESULTS

File records of the patients revealed 19 who experienced a total of 22 episodes of NCs, of whom three had more than one episode. The mean age of 19 patients included in the study, of whom eight were female, was 37.52±13.08 (range, 18-65) years. NCs were classified into central or peripheral depending on the location of involvement of the central nervous system (CNS). CNS involvement was found in 16 (84.2%) of the 19 patients. Tremor (36.8%) was the most common CNS complication in these patients. Encephalopathy, generalized tonic-clonic seizures, and status epilepticus were observed in two patients (10.5%). Delirium and dementia were observed in one patient (5.2%). Headache was experienced by one patient, and agitated depression was observed in one patient. Six patients (26.3%) had the peripheral nervous system involvement. One patient had the numbness of hands with normal electromyography findings, and four patients had polyneuropathy. In one patient, lumbar plexopathy was observed. Seventeen of the 22 NCs were considered to be caused by immunosuppressive agents. Each incidence of amyloidosis, infection, septic emboli, and hypoglycemia caused a neurological episode. The etiology of one episode was unknown.

CONCLUSION

Different neurological disorders can be seen after RT, and most of them are caused by immunosuppressive drugs. NCs seen after RT can be treated by decreasing the dose or changing the immunosuppressive drug.

摘要

引言

本研究旨在评估肾移植(RT)患者神经并发症(NCs)的发生率、类型及相关因素。

方法

回顾性评估2005年1月至2014年7月在我院接受RT的344例患者。

结果

患者档案记录显示,19例患者共经历22次NCs发作,其中3例发作不止一次。纳入研究的19例患者平均年龄为37.52±13.08(范围18 - 65)岁,其中8例为女性。根据中枢神经系统(CNS)受累部位,NCs分为中枢性或周围性。19例患者中有16例(84.2%)出现CNS受累。震颤(36.8%)是这些患者中最常见的CNS并发症。2例患者(10.5%)出现脑病、全身性强直阵挛发作和癫痫持续状态。1例患者(5.2%)出现谵妄和痴呆。1例患者经历头痛,1例患者出现激越性抑郁。6例患者(26.3%)出现周围神经系统受累。1例患者手部麻木,肌电图检查结果正常,4例患者出现多发性神经病。1例患者出现腰丛神经病。22次NCs发作中有17次被认为是由免疫抑制剂引起的。淀粉样变性、感染、脓毒性栓子和低血糖各导致一次神经发作。一次发作的病因不明。

结论

RT后可出现不同的神经障碍,其中大多数由免疫抑制药物引起。RT后出现的NCs可通过减少剂量或更换免疫抑制药物进行治疗。

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