Bruno A, Adams H P
Department of Neurology, University of Iowa College of Medicine, Iowa City.
Neurol Clin. 1988 May;6(2):305-25.
Renal transplant recipients are at an increased risk of developing certain neurologic problems. These problems differ from those encountered in recipients of other organs. Development of atherosclerosis is accelerated in renal transplant patients and results in an increased incidence of thromboembolic events. Immunosuppressive therapy predisposes to infection with opportunistic organisms, including reactivation of latent viruses and also is associated with an increased incidence of de novo neoplasia. The transplantation procedure may be complicated by a neuropathy and occasionally by distal spinal cord infarction. Some immunosuppressive agents have a direct adverse effect on the nervous system, particularly when toxic levels accumulate in the body. Uremia prior to, and if present after transplantation, has a toxic effect on the nervous system as well. The reasons for these problems are discussed. Awareness of these special problems in renal transplant patients will facilitate their prevention and diagnosis. A recommended diagnostic approach has been outlined. After the etiology has been established, treatment can be tailored to the individual patient.
肾移植受者发生某些神经系统问题的风险增加。这些问题与其他器官移植受者所遇到的问题不同。肾移植患者动脉粥样硬化的发展加速，导致血栓栓塞事件的发生率增加。免疫抑制治疗易引发机会性生物体感染，包括潜伏病毒的重新激活，并且还与新发肿瘤的发生率增加有关。移植手术可能并发神经病变，偶尔还会并发脊髓远端梗死。一些免疫抑制剂对神经系统有直接的不良影响，尤其是当体内积累有毒水平时。移植前以及移植后若存在的尿毒症，对神经系统也有毒性作用。文中讨论了这些问题的原因。了解肾移植患者的这些特殊问题将有助于其预防和诊断。文中概述了推荐的诊断方法。在确定病因后，可针对个体患者进行治疗。
