摘要
目的研究髋关节置换术老年患者术后谵妄(POD)与术前脑脊液β淀粉样蛋白(Aβ)-42、Tau及磷酸化Tau(pTau)水平的关系。方法在蛛网膜下腔麻醉下行全髋关节置换术、ASAⅠ或Ⅱ级、年龄65～90岁的老年患者82例,术前应用简易精神状态量表(MMSE)对认知功能进行评定,术后根据谵妄评定法(CAM)将患者分为POD和非POD组。检测术前脑脊液Aβ-42、Tau及pTau水平,记录并分析围术期的相关危险因素。结果髋关节置换术老年患者POD发生率为36.6%,其中年龄及术前认知功能水平为POD的高危因素(P<0.05)。与非POD组比较,POD组患者术前脑脊液中pTau明显升高,而Aβ-42降低(P<0.05)。结论术前脑脊液中pTau及Aβ-42水平与POD发生相关,可以作为预测POD的指标。
Objective , To investigate the relationship between postoperative delirium （POD） and preoperative cerebrospinal fluid （CSF） Amyloid β-protein （Aβ）-42, Tau, and pTau levels in aged patients undergoing total hip-replacement. Methods Eight-two patients with ASA I or II, aged 65- 90 years, scheduled for total hip-replacement surgery with spinal anesthesia were enrolled in the present study. Cognitive function was evaluated by mini-mental state examination （MMSE） preoperatively. Patients were allocated to POD group and non-POD group on the basis of the confusion assessment method of after operation. Preoperative CSF was measured for the levels of Aβ- 42, Tau, and pTau. Risk factors related to delirium were analyzed. Results POD occurred in 36.6% of aged patients undergoing total hip-replacement surgery. Age and preoperative cognitive function were risk factors for delirium. CSF levels of pTau in group POD were significantly higher while Aβ-42 was lower when compared with Non POD group. Conclusion Preoperative CSF levels of Aβ-42 and pTau may be associated with delirium and may serve as predictable biomarkers for delirium.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2012年第11期1067-1069,共3页
Journal of Clinical Anesthesiology
基金
江苏省"科教兴卫工程"医学重点人才课(RC2011136)
全军"十二五"科研面上项目(CWS11J017)
新疆伊犁州科技局课题(YZ201101027)
