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患有术后妄想的老年患者肠道微生物组和代谢组的改变:一项前性嵌套病例对照研究

Jiang Huo¹, Shiyi Han², Xinyu Hao²

¹Department of Anesthesiology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Department of Anesthesiology, The Fifth Medical Center, Chinese PLA General Hospital, Beijing 100071, China.

Journal of clinical anesthesia

|April 14, 2025

概括

这项研究发现,在接受手术的老年患者中,特定的肠道细菌和与术后妄想 (POD) 相关的血代谢物. 这些生物标志物可以帮助预测POD风险并指导干预措施.

科学领域:

微生物组研究微生物组研究
老年医学老年医学
代谢学代谢学代谢学

背景情况:

手术后痴呆症 (POD) 是接受手术的老年患者的常见并发症.
肠道微生物群及其代谢物在POD发展中的作用仍然不完全理解.

研究的目的:

调查肠道微生物群,短链脂肪酸 (SCFA) 和针对性代谢与POD在老年患者之间的关联.
为了确定预测POD风险的潜在生物标志物.

主要方法:

潜在的嵌套病例对照研究,涉及接受选择性骨科手术的老年患者.
使用3分钟诊断混评估方法 (3D-CAM) 评估POD.
16S rRNA测序和便和血样本的代谢学分析,与倾向性得分匹配 (PSM) 进行病例对照比较.

主要成果:

在POD和对照组之间,手术前肠道微生物群多样性 (alpha和beta) 没有显著差异.
特定细菌属 (Romboutsia, Bacteroides faecalis, Blautia mucilaginosa, Eggerthella lenta) 的识别,其丰度不同.
较高的术后血水平的酸,histidine,阿斯巴酸,和奥尼丁与增加的POD风险的关联.
使用肠道微生物群和代谢物指标的预测模型实现了POD预测的AUC为0.8413.

结论:

四种手术前的细菌属和四种手术后的血代谢物与老年骨科患者的POD风险增加有关.
肠道微生物群和代谢物概况显示出改善POD风险预测的生物标志物的潜力.
这些发现表明,基于微生物组和代谢组概况的有针对性的干预措施的潜力.

关键词:

老年人医院老年人医院我们的肠道微生物群.整形外科手术整形外科手术手术后妄症术后妄症短链脂肪酸短链脂肪酸有针对性的代谢组学.

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