J NEUROL NEUROSUR PS：罹患脓毒症可致永久认知及脑功能损害
2012-12-28 J NEUROL NEUROSUR PS CMT 程蓓 翻译
一项多国联合研究显示，对于从重症监护病房（ICU）出院的患者，无论其是否罹患脓毒症，均可出现多个脑区永久性认知功能损害及非特异性脑功能障碍。与健康对照相比，脓毒症幸存者常出现左侧海马萎缩。医生应对ICU患者进行神经保护治疗，避免发生持久的脑功能改变。论文将发表于《神经病学、神经外科学与精神病学杂志》[J Neurol Neurosurg Psychiatry&nb
一项多国联合研究显示，对于从重症监护病房（ICU）出院的患者，无论其是否罹患脓毒症，均可出现多个脑区永久性认知功能损害及非特异性脑功能障碍。与健康对照相比，脓毒症幸存者常出现左侧海马萎缩。医生应对ICU患者进行神经保护治疗，避免发生持久的脑功能改变。论文将发表于《神经病学、神经外科学与精神病学杂志》[J Neurol Neurosurg Psychiatry 2013，84（1）：62]。
研究者选取从ICU出院的脓毒症（n=25）和非脓毒症（n=19）患者，并以现有数据库中的健康者作为对照，随访6~24个月，进行脑部形态学、标准脑电图（EEG）、认知与精神健康状况以及健康相关的生活质量评估。
结果为，与健康对照组相比，脓毒症幸存者存在语言学习和记忆方面认知功能损害，且其左侧海马体积明显缩小。此外，脓毒症幸存者以及某些非脓毒症幸存者会在EEG上表现较多的低频活动，提示存在非特异性脑功能障碍。未发现出院患者与健康对照在健康相关的生活质量、心理功能或抑郁症状（应作为混杂因素被排除）方面存在差异。
Persistent cognitive impairment, hippocampal atrophy and EEG changes in sepsis survivors
Objectives
The objective of this preliminary study was to explore long-term changes in neurobehavioral parameters, brain morphology and electroencephalography of sepsis patients who received intensive care compared to non-septic intensive care unit (ICU) patients.
Methods
Two-centre follow-up study 6–24 months after discharge from hospital using published norms and existing databases of healthy controls for comparison. Patients included 25 septic and 19 non-septic ICU survivors who were recruited from two ICUs of a university and community hospital. Measurements used include brain morphology, standard electroencephalography, cognition and psychiatric health and health-related quality of life.
Results
Sepsis survivors showed cognitive deficits in verbal learning and memory and had a significant reduction of left hippocampal volume compared to healthy controls. Moreover, sepsis and to some extent non-septic ICU patients had more low-frequency activity in the EEG indicating unspecific brain dysfunction. No differences were found in health-related quality of life, psychological functioning or depressive symptoms, and depression could be ruled out as a confounding factor.
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