较大的心脏手术后TDP-43血清水平升高与术后狂妄有关
Christopher Simon1, Occam Kelly Graves1, Oluwaseun Akeju1
1Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
Brain, behavior, & immunity - health
|March 26, 2025
概括
心脏手术患者的术后妄想与TAR DNA结合蛋白 43 (TDP-43) 水平升高有关. 这表明TDP-43可能表明神经损伤,并有助于早期干预认知衰退.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 生物标志物 生物标志物
背景情况:
- 手术后痴呆症是主要心脏手术患者的常见并发症.
- 痴呆症和神经退行性痴呆症之间的因果关系尚不清楚.
- TAR DNA 结合蛋白 43 (TDP-43) 涉及阿尔茨海默病和相关痴呆症.
研究的目的:
- 调查心脏手术患者中术后狂妄和循环TARDNA结合蛋白43 (TDP-43) 水平之间的关联.
- 探索TDP-43作为心脏手术后神经系统并发症的潜在生物标志物.
主要方法:
- 从MINDDS试验生物库测量了60岁以上接受心脏手术的患者的血清TDP-43水平.
- 对手术前和术后第一天的TDP-43水平进行了比较,按 Delirium 状态分层 (混评估方法).
- 一个验证队列评估了心肺旁路术后TDP-43水平的时间变化.
主要成果:
- 与基线相比,术后第一天的血清TDP-43总水平显著增加了16.5%.
- 狂妄症患者的TDP-43中位数增加更为明显 (55.1%).
- 验证队列证实心脏手术后TDP-43升高,在术后第一天下降.
结论:
- 心脏手术后狂妄症与循环TDP-43.3的显著升高有关.
- TDP-43可以作为神经损伤和血脑屏障完整性的预后生物标志物.
- 这些发现提供了对妄和认知障碍的机制性见解,表明了早期干预的潜力.
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