肝移植术后脱髓鞘疾病病因的研究进展

Demyelinative diseases after liver transplantation:the etiology

肝移植术后发生神经系统的脱髓鞘疾病较为少见,但近年有上升的趋势。发病早期易被误诊为免疫抑制剂引起的精神症状,当其表现在中枢神经系统时危害较大,一旦发生将会严重影响肝移植术后患者的早期生存率和长期生活质量。而当其表现在周围神经系统时,多为隐匿起病,给早期诊断和治疗带来不便。因此,对于肝移植术后并发脱髓鞘疾病应以预防为主,了解各种脱髓鞘疾病的发病原因,有助于临床医生防患于未然。但肝移植术后并发脱髓鞘疾病的确切机制仍未明确。本文复习了相关报道,总结了肝移植术后常见脱髓鞘疾病可能的发生机制,为更好地预防和治疗肝移植术后并发脱髓鞘疾病提供参考。

Liver transplantation is the only definitive treatment modality of end stage liver diseases. Demyelinative disease is rarely seen in patients after liver transplantation,but a higher incidence has been noticed recently. The disease is liable to be misdiagnosed as immunosuppressant-induced psychiatric disorders at early stage. Central pontine myelinolysis is more disastrous and it will greatly influence the shortterm survival and long -term life quality of the patients after liver transplantation. When it is manifested as peripheral nervous system disorder,the disease usually has a subtle onset,making it difficult for diagnosis and treatment. The causes for various demyelinative diseases should be understood to prevent it in patients after liver transplantation. The specific mechanism for demyelinative disease after liver transplantation remains unclear. We introduce the possible causes of common demyelinative diseases,hoping to provide reference for prevention and treatment of such con.ditions after liver transplantation.