脊柱手术后细菌细胞外囊作为预测性生物标志物:前性队列研究
Jai J Jee1, Sujung Park2, Jeongmin Kim3
1Department of Pediatrics, Yonsei University College of Medicine, Severance Fecal Microbiota Transplantation Center, Severance Hospital, Seoul, Republic of Korea.
International journal of surgery (London, England)
|August 27, 2025
概括
循环中的细菌细胞外囊 (BEV) 的形状可以预测老年手术患者的术后妄想. 特定的BEV配置文件及其代谢物载荷为POD预防提供了新的策略.
科学领域:
- 微生物学
- 老年医学
- 外科瘤学
背景情况:
- 由于患者群体异质,术后妄的预测具有挑战性.
- 细菌细胞外囊泡 (BEV) 是疾病预测的新兴生物标志物.
- 本研究研究了BEV作为POD预后因素在一个独特的手术患者队列中.
研究的目的:
- 在脊柱外科手术患者中确定术前预后因素.
- 评估细菌细胞外囊泡 (BEVs) 对POD的预测性能.
- 为了推断参与POD病变和神经保护的潜在代谢物.
主要方法:
- 一项对128名脊椎手术患者的前性队列研究.
- 基于基线特征,微生物组数据和BEV概况,使用随机森林分类模型预测POD.
- 进行了in silico分析以推断调节POD的代谢物.
主要成果:
- 在患有POD和没有POD的患者中,循环BEV的概况有显著差异.
- 基于BEV的预测模型达到80%的准确性,优于基于基线特征或肠道微生物组的模型.
- 特定的细菌物种 (Moraxellaceae,Acinetobacter) 和推断的代谢物 (succinate,S-methyl-5'-thioadenosine) 被确定为关键的预后标志物.
结论:
- 在老年手术患者中,循环的BEV概况是POD的关键预后指标.
- 从BEV中推断出的代谢物突出显示了POD预防策略的潜在治疗目标.
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