在患有阻塞性睡眠呼吸暂停的患者中,术前缺氧生物标志物和术后妄想
Martin Breitkopf1, Elena Ahrens2,3, Matthias L Herrmann4,5
1Department of Anesthesiology and Intensive Care, Katharinenhospital Klinikum Stuttgart, Stuttgart, Germany.
Journal of anesthesia
|November 4, 2024
概括
手术后痴呆症 (POD) 发生率呈现下降趋势,阻塞性睡眠呼吸暂停 (OSA) 风险较高,可能是由于缺氧预先条件. 这种关联在所有分析中都不是统计学上强大.
科学领域:
- 麻醉学 麻醉学
- 睡眠医学 睡眠医学
- 神经学 神经学
背景情况:
- 手术后痴呆症 (POD) 是阻塞性睡眠呼吸暂停 (OSA) 患者的一个重大问题,与增加的死亡率和医疗费用有关.
- 研究OSA风险,特定生物标志物和POD之间的关系对于理解和潜在地减轻术后并发症至关重要.
研究的目的:
- 为了检查阻塞性睡眠呼吸暂停 (OSA) 风险,中枢神经缺血症 (S100B和NSE) 的血清生物标志物,以及术后痴呆症 (POD) 的发生之间的关联.
- 探索OSA严重程度,神经标志物和手术后认知结果之间的潜在联系.
主要方法:
- 患者 (n=124) 在选择性手术前接受了OSA风险分层的STOP BANG评估.
- 测量了S100B和NSE的血清水平,并使用蒙特利尔认知评估 (MoCA) 在手术前和手术后评估认知功能.
- 狂妄症使用护理狂妄症查量表 (NuDESC) 和混评估方法 (CAM) 进行评估.
主要成果:
- 手术前的NSE水平显著增加,随着OSA风险的增加 (p=0.039).
- 随着OSA风险的增加,观察到POD发病率下降的趋势 (p=0.043),尽管在完整的病例分析中,这一发现并不强大.
- 手术后认知评估 (MoCA) 和妄查 (NuDESC) 在OSA风险组之间没有显著差异.
结论:
- 报告指出,POD发病率降低的潜在趋势与较高的OSA风险相结合,可能支持低氧预条件的概念.
- 观察到的趋势在统计上并不稳定,表明需要进一步调查OSA,生物标志物和术后结果之间的复杂相互作用.
- 患有POD的患者的血清生物标志物水平根据OSA风险分层没有显著差异.
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