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中国人民解放军总医院老年心血管病研究所
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
王舰,邬晓臣,刘敬臻,何思毅,蒋利,高峰,丁盛,张近宝.神经损伤标志物与老年患者心脏瓣膜置换术后谵妄的相关性[J].中华老年多器官疾病杂志,2020,19(12):886~890
神经损伤标志物与老年患者心脏瓣膜置换术后谵妄的相关性
Correlation between biomarkers for neuronal injury and delirium in elderly patients after cardiac valve replacement surgery
投稿时间:2020-03-12  
DOI:10.11915/j.issn.1671-5403.2020.12.204
中文关键词:  老年人;神经损伤标志物;瓣膜置换术;谵妄
英文关键词:aged; biomarkers for neuronal injury; valve replacement surgery; delirium This work was supported by the National Natural Science Foundation of China
基金项目:国家自然科学基金(81701115)
作者单位E-mail
王舰 西部战区总医院心胸外科,成都 610083 zjbwyw@sina.comcorrelation 
邬晓臣 西部战区总医院心胸外科,成都 610083 zjbwyw@sina.comcorrelation 
刘敬臻 西部战区总医院心胸外科,成都 610083 zjbwyw@sina.comcorrelation 
何思毅 西部战区总医院心胸外科,成都 610083 zjbwyw@sina.comcorrelation 
蒋利 西部战区总医院心胸外科,成都 610083 zjbwyw@sina.comcorrelation 
高峰 西部战区总医院心胸外科,成都 610083 zjbwyw@sina.comcorrelation 
丁盛 西部战区总医院心胸外科,成都 610083 zjbwyw@sina.comcorrelation 
张近宝 西部战区总医院心胸外科,成都 610083 zjbwyw@sina.comcorrelation 
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全文下载次数: 34
中文摘要:
      探讨血浆中神经损伤标志物与老年患者心脏瓣膜置换术后谵妄发生的相关性。方法 将2018年12月至2019年12月在西部战区总医院住院并择期行心脏瓣膜置换手术的老年患者共109例纳入本研究。术后在监护室采用重症监护意识紊乱评估法评估谵妄。对比手术前后患者血浆中神经损伤标志物神经元特异性烯醇酶(NSE)和S100β的表达变化。患者基线资料,采用单因素和多因素logistic回归分析,明确NSE和S100β与谵妄发生的关系及其他谵妄的危险因素。结果 老年患者心脏瓣膜置换术后谵妄发生率为30.3%(33/109)。术后血浆中NSE和S100β水平均较术前明显升高(均P<0.01)。多因素logistic回归分析表明:糖尿病(OR=1.76,95%CI 1.02~2.61;P=0.04)、机械通气时间(OR=3.11,95%CI 1.29~7.52;P<0.01)、NSE浓度(OR=5.94,95%CI 1.53~12.04;P<0.01)及S100β浓度(OR=5.11,95%CI 1.38~10.14;P<0.01)是谵妄发生的危险因素。结论 神经损伤标志物NSE和S100β浓度与老年患者心脏瓣膜置换术后谵妄密切相关,血浆NSE和S100β浓度的升高可能是谵妄发生的有效预测因子。
英文摘要:
      Objective To investigate the correlation between the neuronal injury-related biomarkers and delirium in elderly patients after cardiac valve replacement surgery. Methods A total of 109 elderly patients undergoing elective open-heart valve replacement surgery in General Hospital of Western Theater Command from December 2018 to December 2019 were enrolled in the present study. The confusion assessment method for the intensive care unit was utilized to evaluate the delirium in patients after surgery. The serum concentrations of biomarkers for neuronal injury, neuron-specific enolase (NSE) and S100β were measured and compared before and after surgery. The baseline data of all the patients were collected, and univariate and multivariate logistic regression analyses were conducted to verify the correlations between NSE and S100β with delirium, respectively, and the other risk factors for delirium. Results The incidence of delirium was 30.3% (33/109) in the cohort of patients. The serum concentrations of NSE and S100β were significantly increased after surgery (all P<0.01). Multivariate logistic regression analysis indicated that diabetes (OR=1.76,95%CI 1.02-2.61; P=0.04), duration of mechanical ventilation (OR=3.11,95%CI 1.29-7.52; P<0.01), and serum concentrations of NSE (OR=5.94,95%CI 1.53-12.04; P<0.01) and S100β (OR=5.11,95%CI 1.38-10.14; P<0.01) were risk factors for postoperative delirium. Conclusion Neuronal injury biomarkers NSE and S100β are closely correlated with delirium in elderly patients after cardiac valve replacement surgery. The elevated serum concentrations of NSE and S100β might be potent predictors for delirium.
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