摘要
目的探究颈深淋巴-静脉吻合术治疗阿尔茨海默病的短期疗效及安全性。方法本研究采用病例系列报道研究设计,所有病例资料(共30例)均来源于2024年12月至2025年2月在重庆医科大学附属第一医院神经外科接受颈深淋巴-静脉吻合术(lymphatic-venous anastomosis,LVA)的患者。所有患者明确诊断为阿尔茨海默病,并在术前、术后1周、术后1个月和术后3个月时接受神经精神问卷(neuropsychiatric inventory,NPI)、临床痴呆评定量表(clinical dementia rating,CDR)和日常生活活动能力量表(Activities of daily living,ADL)3项神经心理学量表评估,并以其评分情况作为疗效评价指标。结果所有患者成功接受LVA,无死亡病例及严重不良事件发生。NPI评分中位数术后1周16.0(7.2,21.5)较术前25.5(13.8,47.5)降低(P<0.001,r=0.74),术后1个月17.0(8.5,23.8)及术后3个月17.5(12.0,21.0)基本保持稳定且与术前有统计学差异(P<0.001);ADL评分均值术后1周(54.9±16.2)较术前(56.7±16.6)降低(P<0.001),术后1个月(53.7±16.0)进一步降低(P<0.001),术后3个月(56.2±13.9)仍低于术前但不再具有统计学差异(P=0.701);CDR总分(Clinical dementia rating scale Sum of Boxes,CDR-SB)中位数术后1周15.0(13.0,16.0)较术前16.0(13.2,17.0)降低,差异具有统计学意义(P<0.001,r=0.63),术后1个月及术后3个月均与术前有统计学差异。结论LVA治疗阿尔茨海默病表现出较高的安全性,并对阿尔茨海默病症状改善具有一定的短期效果。
Objective To investigate the short-term efficacy and safety of deep cervical lymphaticvenous anastomosis(LVA)in treating Alzheimer disease.Methods This case series included 30 patients who underwent LVA at the Department of Neurosurgery,First Affiliated Hospital of Chongqing Medical University between December 2024 and February 2025.All patients had confirmed Alzheimer disease and were assessed preoperatively and at 1 week,1 month,and 3 months postoperatively using three standardized neuropsychological scales:Neuropsychiatric Inventory(NPI),Clinical Dementia Rating Scale Sum of Boxes(CDR-SB),and Activities of Daily Living(ADL)scale.Changes in these scores served as efficacy endpoints.Results All patients successfully underwent LVA with no mortality or severe adverse events.Median NPI scores decreased from 25.5(13.8,47.5)preoperatively to 16.0(7.2,21.5)at 1 week postoperatively(P<0.001,r=0.74),remaining stable at 17.0(8.5,23.8)and 17.5(12.0,21.0)at 1 and 3 months respectively(P<0.001 vs.baseline).Mean ADL scores decreased from 56.7±16.6 preoperatively to 54.9±16.2 at 1 week(P<0.001),further declined to 53.7±16.0 at 1 month(P<0.001),and returned to 56.2±13.9 at 3 months(P=0.701 vs baseline).Median CDR-SB significantly improved from 16.0(13.2,17.0)preoperatively to 15.0(13.0,16.0)at 1 week(P<0.001,r=0.63),with sustained improvements at 1 and 3 months(P<0.001).Conclusion LVA demonstrates favorable safety and modest short-term efficacy in ameliorating neuropsychiatric symptoms and cognitive function in Alzheimer disease.
作者
龙定睿
吴继祥
庞华
邓辉胜
杨刚
石全红
吕洋
李旭
李国民
程崇杰
承欧梅
LONG Dingrui;WU Jixiang;PANG Hua;DENG Huisheng;YANG Gang;SHI Quanhong;LYU Yang;LI Xu;LI Guomin;CHENG Chongjie;CHENG Oumei(Department of Neurology,The First Affiliated Hospital of Chongqing Medical University,Chongqing;Department of Neurosurgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing;Department of Nuclear Medicine,The First Affiliated Hospital of Chongqing Medical University,Chongqing;Department of General Practice,The First Affiliated Hospital of Chongqing Medical University,Chongqing;Department of Geriatrics,The First Affiliated Hospital of Chongqing Medical University,Chongqing)
出处
《陆军军医大学学报》
北大核心
2025年第24期3130-3138,共9页
Journal of Army Medical University
基金
国家自然科学基金面上项目(81871002)
重庆市教育委员会科学技术研究项目(KJQN202200469)。
关键词
阿尔茨海默病
颈深淋巴静脉吻合术
外科治疗
认知障碍
神经退行性疾病
Alzheimer’s disease
Deep cervical lymphatic-venous anastomosis
Surgical treatment
Cognitive impairment
Neurodegenerative diseases
