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鼻内胰岛素对手术后认知功能障碍的保护作用,在接受非心脏手术的老年代谢综合征患者中:一项随机临床试验
Yang Mi1, Ouyang Wen1, Long Ge1
1Department of Anesthesia, The Third Xiangya Hospital of Central South University, Changsha, China.
Aging clinical and experimental research
|November 22, 2023
概括
鼻内胰岛素显著降低了代谢综合征的老年患者手术后认知功能障碍 (POCD) 的发生率,改善了认知功能并减少了炎症.
科学领域:
- 神经科学是一个神经科学.
- 内分泌学 在内分泌学.
- 老年病的医生 老年病的医生
背景情况:
- 胰岛素对认知功能至关重要;胰岛素抵抗与神经退行性和代谢性疾病有关.
- 胰岛素耐药性有助于术后认知功能障碍 (POCD) 病理生理学,可以通过鼻内胰岛素减轻.
- 这项研究研究了鼻内胰岛素对代谢综合征的老年人POCD的影响.
研究的目的:
- 评估鼻内胰岛素在预防代谢综合征的老年患者中预防POCD的疗效.
- 评估鼻内胰岛素对术后认知功能,胰岛素抵抗和炎症的影响.
主要方法:
- 一个随机,双盲,安慰剂控制的试验,涉及116名老年参与者.
- 参与者接受了40 IU的鼻内胰岛素或安慰剂七天.
- 主要结局:手术后7天和3个月的POCD发病率;次要结局:周围胰岛素抵抗,炎症和安全性.
主要成果:
- 在手术后7天,胰岛素组 (20.8%) 和安慰剂组 (45.1%) 的POCD发病率较低 (P=0.008).
- 胰岛素组在语言和记忆测试中表现出更好的认知表现 (P<0.05).
- 在手术后的第3天和第7天,鼻内胰岛素显著降低了TNF-α (P<0.05) 和CRP (P<0.001) 的外周水平.
结论:
- 鼻内胰岛素有效降低了代谢综合征的老年患者POCD的发生率.
- 治疗还减轻了外围炎症标志物,这表明了潜在的认知改善机制.
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