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目的 初步探讨肾移植受者 (RTR)神经精神损害 (NPD)的影响因素及其发病机制。方法 对 2 0 5例 RTR的临床资料进行回顾性分析。结果 本组病例的 NPD发生率为 38% ,类型包括 :脑脓肿、昏迷、颅神经损害、抽动、肌无力、脊神经损害、神经衰弱症状群、精神症状和震颤。排斥反应、高血压、肝损害、医院感染、Cs A中毒和应用大剂量甲基泼尼松为本组 NPD的主要影响因素 (P <0 .0 1) ;高脂血症、高尿酸血症、高血糖、贫血、红细胞增多症和电解质紊乱也是NPD的影响因素。结论 RTR中 NPD的发生率较高 ,与其它系统并发症和某些药物密切相关。应重视 RTR其它系统并发症的防治和强调合理用药 ,以切实减少 NPD的发生。
Objective To investigate the influencing factors and pathogenesis of neuropathic impairment (NPD) in renal allograft recipients (RTR). Methods The clinical data of 205 cases of RTR were retrospectively analyzed. Results The incidence of NPD in this group of patients was 38%. The types included: brain abscess, coma, cranial nerve damage, twitching, muscle weakness, spinal nerve damage, neurasthenic symptoms, psychotic symptoms and tremor. Rejection, hypertension, liver damage, nosocomial infection, CsA poisoning and the application of high-dose methylprednisone were the main influencing factors of NPD in this group (P <0.01); hyperlipidemia, hyperuricemia , Hyperglycemia, anemia, polycythemia and electrolyte imbalance are also the influencing factors of NPD. Conclusion The incidence of NPD in RTR is high, which is closely related to other systemic complications and some drugs. Should pay attention to the prevention and treatment of other systemic complications of RTR and emphasize the rational use of drugs in order to effectively reduce the occurrence of NPD.