S.S. Lacerda, M.S. Guimaro, C.V. Prade, B.H. Ferraz-Neto, C.H. Karam, P.B.A. Andreoli

简介：慢性肾病和慢性肝病与认知缺损和智力障碍有一定的关系，在肾移植或肝移植后这种慢性肾病或肝病仍然不能逆转。

目标：我们的目的是调查器官移植候选人中存在的认知功能障碍患者。

方法：从2005年5月至2006年3月期间共35名器官移植患者，平均年龄为46.71（± 13.01）岁，54.3%为女性，接受平均7.29（± 4.22）年的正规教育。在这些患者中，27名（77%）为肾移植候选人，8名（23%）为肝移植候选人。所有的患者都进行了神经心理学评估，以此来评价患者的注意力、行政功能、记忆力、语言、视觉空间能力以及智力技能。

结果：经过研究我们发现了患者存在以下几个方面的损伤：注意力（注意广度[34.3%]，持续注意力[76.5%]，分散注意[77.8%]）、行政功能（分类信息[58.3%]，误差[61.5%]、固着误差[30.4%]）、记忆力（暂时记忆力[57.1%]，形象 [37.1%]和视觉短期记忆[31.4%]，形象[25.7%]和视觉长期记忆[51.4]，语言学习[42.9%]，传导灵敏度[42.9%]和形象认知记忆力[20.6%]）、语言能力（理解力[38.1%]，词汇[30.8%]）、视觉空间能力(45.8%)以及智力技能（50.0%）。

结论：不管是何种类型的移植，患者出现神经心理学（认知）障碍都是很频繁的。这些障碍涉及到患者的多种认知技能，例如注意力、行政功能、记忆力、语言能力、视觉空间能力和智力技能。因此我们得出结论，移植前的神经心理学评估是发现移植患者认知功能障碍的重要方法，有助于了解这些障碍是如何干预患者移植前和移植后的自我监护能力的。

Neuropsychological Assessment in Kidney and Liver Transplantation Candidates
S.S. Lacerda, M.S. Guimaro, C.V. Prade, B.H. Ferraz-Neto, C.H. Karam, P.B.A. Andreoli

Introduction：Chronic renal and liver diseases are associated with cognitive and intellectual impairment, which can be irreversible even after kidney or liver transplantation.

Objective：We sought to investigate the presence of cognitive deficits in organ transplantation candidates.

Methods：From May 2005 to March 2006, 35 organ transplantation candidates, of mean age 46.71 (± 13.01) years, 54.3% including females and 7.29 (± 4.22) years mean formal schooling. Of those, 27 (77%) were renal and 8 (23%), liver transplantation candidates. All subjects underwent a neuropsychological assessment battery designed to evaluate attention performance, executive functions, memory, language, visuaospatial, and intellectual skills.

Results：We found impairments in attention performance (attention span [34.3%], sustained attention [76.5%], and divided attention [77.8%]), executive functions (category formation [58.3%], errors [61.5%], and perseverative errors [30.4%]), memory (working memory [57.1%], verbal [37.1%] and visual short-term memory [31.4%], verbal [25.7%] and visual long-term memory [51.4], verbal learning [42.9%], interference susceptibility [42.9%], and verbal recognition memory [20.6%]), language (comprehension [38.1%], and vocabulary [30.8%]), visuaospatial (45.8%), and intellectual skills (50.0%).

Conclusion：Neuropsychological (cognitive) deficits in transplant candidates are frequent, regardless of the kind of transplantation. The deficits involve several cognitive skills, such as attentional processes, executive functions, memory, language, visuaospatial, and intellectual skills. Therefore, we concluded that a pretransplant neuropsychological assessment is an important measure to detect impairments and to help understand how these difficulties can interfere with patient self-care before and after transplantation.

Volume 40, Issue 3, Pages 729-731 (April 2008)

[责任编辑:刘 聪]