1 Department of Geriatric Medicine, Prince of Wales Hospital, Sydney, Australia.
J Gerontol A Biol Sci Med Sci. 2010 Oct;65(10):1130-6. doi: 10.1093/gerona/glq090. Epub 2010 Jun 7.
Delirium is a common syndrome affecting older people in hospital, whose pathophysiology is poorly understood, but sequelae of increased cognitive and functional impairment suggest neuronal loss.
Cohort study comparing cerebrospinal fluid, blood, and clinical markers of delirium and neuronal cell death in 20 older hospitalized patients with delirium and 20 outpatients with Alzheimer's dementia.
Compared with participants with dementia, patients with delirium demonstrated higher CSF lactate (1.87 vs 1.48 mmol/L, p < .001) and protein levels (0.62 vs 0.44 g/L, p = .036) and lower levels of neuron-specific enolase (4.84 vs 8.98 ng/mL, p < .001) but no difference in S100B. The changes correlated with clinical indices and outcomes.
Older patients with delirium experience significant metabolic disturbance in the brain, which requires further investigation.
谵妄是一种常见的综合征，影响住院的老年人，其病理生理学知之甚少，但认知和功能损害的后遗症表明存在神经元丢失。
对 20 名患有谵妄的住院老年患者和 20 名患有阿尔茨海默病痴呆的门诊患者进行了比较脑脊液、血液和谵妄与神经元细胞死亡的临床标志物的队列研究。
与痴呆患者相比，谵妄患者的脑脊液乳酸水平更高（1.87 比 1.48 mmol/L，p <.001）和蛋白水平更高（0.62 比 0.44 g/L，p =.036），神经元特异性烯醇化酶水平更低（4.84 比 8.98 ng/mL，p <.001），但 S100B 无差异。这些变化与临床指标和结果相关。
患有谵妄的老年患者大脑中存在明显的代谢紊乱，需要进一步研究。
