手术前的布基胆酶活性和术后妄想风险:一个元分析
Yuan-Li Qiu1, Cheng Song1, Cui-Wan Huang1
1Department of Anesthesiology, Affiliated Hospital of Shaoxing University, Shaoxing 312000, Zhejiang Province, China.
World journal of psychiatry
|January 29, 2026
概括
较低的手术前血清乙基胆酶 (BuChE) 活性与手术患者手术后狂妄症 (POD) 的风险较高有关. 这一发现表明BuChE可能是预测POD风险的有用生物标志物.
科学领域:
- 神经科学是一个神经科学.
- 老年医学 老年医学
- 手术并发症 手术并发症
背景情况:
- 手术后痴呆症 (POD) 是一种普遍且严重的并发症,影响手术患者,特别是老年人.
- 胆固醇系统功能障碍是POD发展的一个可疑因素.
研究的目的:
- 进行元分析,评估手术前血清胆酶 (ChE) 活性 (丁胆酶[BuChE]和乙胆酶[AChE]) 与POD风险之间的关联.
- 为了确定POD风险分层的潜在手术前生物标志物.
主要方法:
- 在PubMed,EMBASE和Web of Science的系统文献搜索到2025年3月.
- 对13项研究 (n=2730) 的元分析,使用随机效应模型将标准化平均差异 (SMD) 和赔率比率 (OR) 结合起来.
- 进行了子组和灵敏度分析,以评估研究结果的可靠性.
主要成果:
- 较低的手术前BuChE活动与POD风险增加显著相关 (SMD = -0.28;95%CI: -0.39至 -0.16).
- 较高的BuChE活性与降低的POD风险相关 (每100个单位的OR增量=0.97;95%CI:0.95-0.99).
- 在POD和非POD组之间,没有发现POD和非POD组在聚合的ACHE活动中存在显著的差异,且ORs不显著.
结论:
- 减少手术前血清BuChE活性是成年手术患者发生POD的重要危险因素.
- 血清BuChE活性显示为POD风险分层的手术前生物标志物具有前景.
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