帕雷科克西布对高脂血症患者手术后的作用:一个随机,双盲,单中心,优越性试验
Zeng Daojun1,2,3, Tang Yuling1,2,3, Xu Yingzhe1,2,3
1Department of Anaesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan Province, China.
术前的帕雷科克西布在高脂血症患者中显著降低了术后狂妄症. 这种干预有效降低了神经炎症和疼痛,为预防妄想提供了一个有希望的策略.
科学领域:
- 麻醉学和外科手术期间的医学.
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 超脂血是患上术后狂妄症的已知危险因素.
- 前列腺素内氧化合成酶-2 (PTGS-2) 在调解与术后妄想相关的神经炎症方面发挥着关键作用.
研究的目的:
- 研究与安慰剂相比,手术前帕雷科克西布在预防高脂血症患者手术后狂妄症方面的疗效.
- 评估帕雷科克西布对出现妄想,PTGS-2水平,炎症标志物和疼痛的影响.
主要方法:
- 一个随机的,双盲的优越性试验,涉及452名患有高脂血症的成年患者.
- 参与者在麻醉诱导前接受了40毫克静脉注射帕雷科克西布或安慰剂.
- 主要结局是三天内术后妄想的发生率;次要结局包括出现妄想,PTGS-2水平,炎症细胞计数和疼痛评分.
主要成果:
- 与安慰剂组相比,帕雷科克西布组 (13.72%) 的术后狂妄发作的发生率明显较低 (12.39%的减少,P < 0.001).
- 帕雷科克西布组表现出出现狂妄症的发病率降低,PTGS-2水平降低,白细胞和中性粒细胞数量降低,术后第一天疼痛评分降低.
- 两组之间不良事件的发生情况相似,PTGS-2水平,炎症标志物和疼痛评分介导了妄的减少.
结论:
- 在手术前给予帕雷科克西布,可有效降低患有高脂血症的患者手术后 Delirium 的发生率.
- 抑制PTGS-2和有效的手术后疼痛管理可能是帕雷科克西布防止妄想的关键机制.
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