外科手术后30天内老年糖尿病患者的外科神经认知障碍变化:一项回顾性队列研究
Keke Song1, Rongrong Zhang1, Xiaoqi Zhao1
1The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, Shaanxi, 710061, China.
Aging clinical and experimental research
|October 17, 2023
概括
老年糖尿病患者在手术后患上术前神经认知障碍 (PND) 的发病率较高. 使用蒙特利尔认知评估 (MoCA) 的术前认知评估是该人群中PND的关键预测因素.
科学领域:
- 老年医学 老年医学
- 神经科学是一个神经科学.
- 内分泌学 在内分泌学.
背景情况:
- 术后神经认知障碍 (PND) 在老年人中很常见,包括术后妄想和神经认知恢复延迟.
- 糖尿病是一种重要的独立风险因素,有助于PND的发展.
- 关于糖尿病和非糖尿病老年患者之间的PND发病率差异和血清生物标志物的研究有限.
研究的目的:
- 为了比较中国老年糖尿病患者与非糖尿病患者中PND的发病率.
- 在老年糖尿病患者中确定PND的特定风险因素.
- 为了研究糖尿病患者和非糖尿病患者之间血清生物标志物的差异.
主要方法:
- 来自先前研究的数据的二次分析,涉及65岁或以上的患者,在全身麻醉下接受非心脏手术.
- 认知功能使用重症监护室 (CAM-ICU) 和蒙特利尔认知评估 (MoCA) 的混乱评估方法进行评估.
主要成果:
- 在糖尿病患者中,30天内PND的发生率明显高于非糖尿病患者 (36.8%),而糖尿病患者的发生率高于59.2% (36.8%).
- 术前的MoCA得分被确定为PND的独立风险因素 (OR 0.88,P=0.014),预测的最佳截止值为21.5分.
- 与非糖尿病患者相比,患有PND的糖尿病患者的状纤维酸蛋白 (GFAP) 和Tau水平显著升高.
结论:
- 与非糖尿病患者相比,老年糖尿病患者的PND发病率较高.
- 手术前的MoCA是老年糖尿病患者PND的关键独立预测因子.
- 增加的GFAP和p-Tau水平与糖尿病患者的PND有关.
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