Çinar Mehmet Alper, Balikçi Adem, Sertoğlu Erdim, Mehmet A K, Serdar Muhittin A, Özmenler Kamil Nahit
Department of Consultation Liaison Psychiatry, TAF Rehabilitation Center, Ankara, Turkey.
Department of Psychiatry, Gülhane Military Medical Academy, Ankara, Turkey.
Noro Psikiyatr Ars. 2014 Dec;51(4):376-382. doi: 10.5152/npa.2014.6999. Epub 2014 Dec 1.
Delirium is a common and life-threatening neuropsychiatric syndrome. Diagnosing delirium can be challenging, which increases mortality and mortality rates and health care costs. The biologic model of delirium is not definite yet, but evidence supports a cholinergic deficiency model. Delirium may be the result of processes and drugs that trespass a compromised blood-brain barrier. We aimed to evaluate the possible diagnostic utilization and the role of certain biomarkers, such as C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and insulin like growth factor-1 (IGF-1), in delirium etiology.
A total of 93 inpatients that planned to undergo cardiovascular surgery were informed; 35 of them completed the study. Medical history and current cognitive status were evaluated pre-operatively. Participants were followed using Delirium Rating Scale-Revised-98 Turkish (DRS-R98-T) for delirium symptoms, and blood samples were collected post-operatively.
Delirium was developed more in participants who had worse pre-operative cognitive status. Also, low pre-operative IGF-1 levels were detected in the delirium group. Pre-operative CRP and TNF-α levels were not different between groups.
Low IGF-1 levels can be used to predict delirium after surgery. However, the complex nature of cytokines and delirium itself make it difficult to utilize cytokines to predict delirium instead of psychometric tools.
谵妄是一种常见且危及生命的神经精神综合征。诊断谵妄具有挑战性，这会增加死亡率和发病率以及医疗保健成本。谵妄的生物学模型尚未明确，但有证据支持胆碱能缺乏模型。谵妄可能是突破受损血脑屏障的过程和药物所致。我们旨在评估某些生物标志物，如C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）和胰岛素样生长因子-1（IGF-1）在谵妄病因学中的可能诊断用途及作用。
共告知93例计划接受心血管手术的住院患者；其中35例完成了研究。术前评估病史和当前认知状态。使用土耳其语修订版谵妄评定量表-98（DRS-R98-T）对参与者进行谵妄症状随访，并在术后采集血样。
术前认知状态较差的参与者发生谵妄的情况更多。此外，谵妄组术前IGF-1水平较低。术前CRP和TNF-α水平在各组之间无差异。
低IGF-1水平可用于预测术后谵妄。然而，细胞因子和谵妄本身的复杂性使得难以利用细胞因子而非心理测量工具来预测谵妄。
