移植前心理测量测试能否预测活体肾移植后他克莫司的患者内变异性？
Can Pre-Transplant Psychometric Testing Predict Tacrolimus Intrapatient Variability After Living Kidney Transplantation?
作者信息
Lee Ah Rah, Lee Sang Min, Kang Won Sub, Cho Ah Rang, Kim Jong Woo, Park Jin Kyung
机构信息
Department of Psychiatry, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea.
Department of Psychiatry, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
出版信息
Psychiatry Investig. 2024 Jul;21(7):718-725. doi: 10.30773/pi.2024.0058. Epub 2024 Jul 24.
OBJECTIVE
Tacrolimus intrapatient variability (Tac IPV) has been considered a marker for post-graft risk. We investigated pre-transplant psychometric testing to predict Tac IPV after living kidney transplantation.
METHODS
Minnesota Multiphasic Personality Inventory-2 (MMPI-2) examined during pre-transplant evaluation by 102 recipients were analyzed. Subjects were divided into two groups, low IPV (L-IPV) and high IPV (H-IPV), by cutoffs of Tac IPV: median of 24 and value of 30. T-scores of MMPI-2 scales were used to analyze difference between L-IPV and H-IPV using independent t-tests. Stepwise multiple logistic regression was used to test whether MMPI-2 scales affected Tac IPV. Confusion matrix of logistic regression was used to explain statistical power. Cutoff values of significant scales for H-IPV were analyzed by constructing receiver operating characteristic curves.
RESULTS
Hysteria (Hy) and depression (D) scale scores and Tac IPV were associated in IPV 24 (odds ratio [OR]: 1.08, p<0.01 for Hy; OR: 0.93, p<0.01 for D) and IPV 30 models (OR: 1.09, p<0.01 for Hy; OR: 0.92, p<0.01 for D). Paranoia (Pa) scale scores were associated with Tac IPV in IPV 24 model (OR=1.10, p<0.01) and were significantly higher in H-IPV 24 (p<0.01). F1 scores of confusion matrix in IPV 24 and 30 models were 0.70 and 0.71, respectively. Cutoffs of Hy, D, and Pa scales were 51, 57, and 47, respectively.
CONCLUSION
MMPI-2 profile is suggested as a predictor for high Tac IPV after living kidney transplantation.
目的
他克莫司患者内变异性（Tac IPV）被视为移植后风险的一个标志物。我们研究了移植前心理测量测试以预测活体肾移植后的Tac IPV。
方法
分析了102名接受者在移植前评估期间进行的明尼苏达多相人格调查表第二版（MMPI-2）测试结果。根据Tac IPV的临界值将受试者分为两组，低IPV（L-IPV）组和高IPV（H-IPV）组：Tac IPV中位数为24，临界值为30。使用独立t检验，通过MMPI-2量表的T分数分析L-IPV组和H-IPV组之间的差异。采用逐步多元逻辑回归来检验MMPI-2量表是否影响Tac IPV。使用逻辑回归的混淆矩阵来解释统计功效。通过构建受试者工作特征曲线分析H-IPV组显著量表的临界值。
结果
癔症（Hy）和抑郁（D）量表得分与IPV 24模型（优势比[OR]：Hy为1.08，p<0.01；D为0.93，p<0.01）及IPV 30模型（OR：Hy为1.09，p<0.01；D为0.92，p<0.01）中的Tac IPV相关。偏执狂（Pa）量表得分与IPV 24模型中的Tac IPV相关（OR=1.10，p<0.01），且在H-IPV 24组中显著更高（p<0.01）。IPV 24和30模型中混淆矩阵的F1分数分别为0.70和0.71。Hy、D和Pa量表的临界值分别为51、57和47。
结论
MMPI-2剖面图被认为是活体肾移植后高Tac IPV的一个预测指标。
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