在心胸外科手术或皮肤门置换后患有术后狂妄症的患者中,丁胆酶活性 - 一项观察性跨学科队列研究
Konstantin Schlake1, Johannes Teller2, Lukas Hinken3
1Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. schlake.konstantin@mh-hannover.de.
BMC neurology
|February 29, 2024
概括
丁胆酶 (BChE) 活性不是心脏手术后手术后痴呆症的独立预测因素. 手术前的BChE水平反映了患者的脆弱性,而手术后的水平表明了手术的严重程度和并发症.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 生物化学 生物化学
背景情况:
- 手术后痴呆症是心脏手术后的一种严重并发症.
- 在手术后痴呆症的发展中,丁胆酶 (BChE) 活性在术后痴呆症的作用是有争议的.
- 调查BCHE作为妄的潜在生物标志物对于患者的治疗结果至关重要.
研究的目的:
- 为了评估Butyrylcholinesterase (BChE) 活性作为术后狂妄症的生物标志物.
- 评估心脏或皮肤门置换手术后的BChE水平和狂妄症发生之间的关联.
主要方法:
- 研究了237名接受选择性心胸或皮肤门置换手术的患者.
- 用蒙特利尔认知评估 (MoCA) 评估认知功能.
- 使用3D-CAM或CAM-ICU监测术后妄想.
- 测量了布基胆酶 (BChE) 活性在三个时间点:手术前和手术后.
主要成果:
- 在39.7%的患者中发生了术后妄想.
- 单变量分析表明BChE活动和妄想之间存在关联,但多变量分析显示没有独立的关联.
- 在老年患者和有中风或滥用酒精病史的患者中,术前BChE活性较低.
- 较低的术后BChE活性与较长的手术,心肺旁路使用,红细胞输血和年龄较大相关.
结论:
- 甲醇化酶 (BChE) 活性与术后狂妄症的发生没有独立关联.
- 手术前的BChE水平反映了患者的发病率和脆弱性.
- 手术后的BChE活动表明了手术的严重程度,持续时间和并发症.
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