Baranyi Andreas, Rothenhäusler Hans-Bernd
Department of Psychiatry, University of Medicine of Graz, Auenbruggerplatz 31, Graz, Austria.
Department of Psychiatry, University of Medicine of Graz, Auenbruggerplatz 31, Graz, Austria; Department of Psychiatry, Ludwig-Maximilians University of Munich, Nußbaumstraße, Munich, Germany.
Psychosomatics. 2014 Jan-Feb;55(1):51-60. doi: 10.1016/j.psym.2013.06.004. Epub 2013 Aug 13.
Biomarkers might help to predict the emergence of delirium. Advance warning of the threats of this condition could potentially reduce significant morbidity, mortality, and costs of hospitalizing patients.
Our prospective study investigates for the first time the impact of soluble interleukin-2 receptor (sIL-2R) as a biomarker of delirium after cardiac surgery with cardiopulmonary bypass (CPB).
A total of 34 patients who underwent elective cardiac surgery with CPB were enrolled. During the intensive care unit (ICU) stay and after discharge from the ICU, the delirious state was evaluated daily using the Delirium Rating Scale by Trzepacz. sIL-2R was assayed before CPB, 24 hours postoperatively, and on the day before discharge.
After CPB, 11 patients (32.4%) developed delirium. A short-term delirious state (less than 1 day) was observed in 3 patients and a prolonged delirious state in 8 patients. During the study period, sIL-2R levels decreased 24 hours postoperatively and increased afterward (Friedman test; p < 0.001). As shown by the Spearman rank correlation, CPB patients with higher Delirium Rating Scale scores 72 hours, 96 hours, and 120 hours postoperatively had significant higher sIL-2R levels 24 hours postoperatively. In CPB patients with a prolonged postoperative delirious state, the sIL-2R level is statistically significantly elevated 24 hours postoperatively in comparison with CPB patients without a postoperative delirium (Mann-Whitney U: 48.5, p = 0.049).
High levels of sIL-2R appear to be a useful biomarker to identify patients with high risk for a delirious state.
生物标志物可能有助于预测谵妄的发生。对这种情况的威胁进行提前预警可能会降低患者住院的显著发病率、死亡率和成本。
我们的前瞻性研究首次调查了可溶性白细胞介素-2受体（sIL-2R）作为体外循环（CPB）心脏手术后谵妄生物标志物的影响。
共纳入34例接受择期CPB心脏手术的患者。在重症监护病房（ICU）住院期间和从ICU出院后，每天使用Trzepacz的谵妄评定量表评估谵妄状态。在CPB前、术后24小时和出院前一天检测sIL-2R。
CPB后，11例患者（32.4%）发生谵妄。3例患者出现短期谵妄状态（少于1天），8例患者出现长期谵妄状态。在研究期间，sIL-2R水平在术后24小时下降，随后升高（Friedman检验；p < 0.001）。如Spearman等级相关性所示，术后72小时、96小时和120小时谵妄评定量表评分较高的CPB患者术后24小时sIL-2R水平显著更高。在术后出现长期谵妄状态的CPB患者中，与未出现术后谵妄的CPB患者相比，术后24小时sIL-2R水平在统计学上显著升高（Mann-Whitney U：48.5，p = 0.049）。
高水平的sIL-2R似乎是识别谵妄高风险患者的有用生物标志物。
