老年非心脏手术患者血浆环状RNA-089763与术后认知功能障碍的相关性
Correlation Between Plasma CircRNA-089763 and Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Non-cardiac Surgery.
作者信息
Zhou Hongli, Li Fuyu, Ye Wanlin, Wang Maozhou, Zhou Xian, Feng Jianguo, Liu Li, Wang Xiaobin
机构信息
Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
出版信息
Front Behav Neurosci. 2020 Oct 6;14:587715. doi: 10.3389/fnbeh.2020.587715. eCollection 2020.
In our previous experiment, we found that there were abnormal levels of circRNA-089763 in the plasma exosomes of patients with postoperative cognitive dysfunction (POCD) after cardiac surgery. Therefore, the aim of this study was to further investigate the relationship between plasma circRNA-089763 level and POCD in elderly patients after non-cardiac surgery. A prospective cohort study was conducted to select elderly patients undergoing elective non-cardiac surgery. A total of 72 patients were enrolled in this study, and cognitive functions were assessed 1 day before and 3 days after surgery by a series of neuropsychological measurements. Next, patients were divided into POCD and non-POCD (NPOCD) groups according to the score method. Blood was collected the day before and 3 days after surgery, and the plasma circRNA-089763 level was detected by quantitative real-time polymerase chain reaction (qRT-PCR). Then, the difference and correlation in plasma circRNA-089763 levels between the POCD and NPOCD groups were analyzed. On the third day after surgery, the incidence of POCD was 30.56%. The relative level of circRNA-089763 in the POCD group was 2.41 times higher than that in the NPOCD group ( = 4.711, < 0.001), patients in POCD group had higher age ( = 5.971, < 0.001), higher American Society of Anesthesiologists classification (χ = 14.726, < 0.001), less years of education ( = 2.449, = 0.017), more intraoperative blood loss ( = 3.196, = 0.002), and higher visual analog scale (VAS) scores ( = 10.45, < 0.001). The binary logistic regression analysis showed that the circRNA-089763 level, age, and intraoperative blood loss were independently associated with POCD (OR: 2.75, 95% CI: 1.261-5.999, = 0.011; OR: 1.32, 95% CI: 1.114-1.565, = 0.001; OR: 1.017, 95% CI: 1.004-1.03, = 0.011). These results demonstrated that the circRNA-089763 plasma level was related to POCD after non-cardiac surgery in elderly patients.
在我们之前的实验中，我们发现心脏手术后发生术后认知功能障碍（POCD）的患者血浆外泌体中circRNA - 089763水平异常。因此，本研究的目的是进一步探讨老年患者非心脏手术后血浆circRNA - 089763水平与POCD之间的关系。进行了一项前瞻性队列研究以选择接受择期非心脏手术的老年患者。本研究共纳入72例患者，术前1天和术后3天通过一系列神经心理学测量评估认知功能。接下来，根据评分方法将患者分为POCD组和非POCD（NPOCD）组。在术前1天和术后3天采集血液，通过定量实时聚合酶链反应（qRT - PCR）检测血浆circRNA - 089763水平。然后，分析POCD组和NPOCD组之间血浆circRNA - 089763水平的差异及相关性。术后第3天，POCD的发生率为30.56%。POCD组中circRNA - 089763的相对水平比NPOCD组高2.41倍（t = 4.711，P < 0.001），POCD组患者年龄更大（t = 5.971，P < 0.001），美国麻醉医师协会分级更高（χ² = 14.726，P < 0.001），受教育年限更少（t = 2.449，P = 0.017），术中失血量更多（t = 3.196，P = 0.002），视觉模拟评分（VAS）更高（t = 10.45，P < 0.001）。二元逻辑回归分析显示，circRNA - 089763水平、年龄和术中失血量与POCD独立相关（OR：2.75，95%CI：1.261 - 5.999，P = 0.011；OR：1.32，95%CI：1.114 - 1.565，P = 0.001；OR：1.017，95%CI：1.004 - 1.03，P = 0.011）。这些结果表明，老年患者非心脏手术后血浆circRNA - 089763水平与POCD有关。
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