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在老年骨科手术应激后,神经肽催产素与神经精神障碍之间的关系。

The association between neuropeptide oxytocin and neuropsychiatric disorders after orthopedic surgery stress in older patients.

机构信息

Drug Safety Evaluation Center, Heilongjiang University of Chinese Medicine, Harbin, 150040, China.

National Institute On Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing, 100191, China.

出版信息

BMC Geriatr. 2023 Jul 7;23(1):416. doi: 10.1186/s12877-023-03989-w.

Abstract

BACKGROUND

The health outcomes of geriatric patients exposed to surgery were found to be enhanced by social support and stress management. The aim of this study was to characterise the relationship between oxytocin and neuropsychiatric disorders after surgery.

METHODS

A total of 132 geriatric patients aged ≥ 60 years received orthopedic surgery in the First Affiliated Hospital of Harbin Medical University (Harbin, China) were enrolled in the present study. The salivary levels of stress hormone cortisol and oxytocin were measured by enzyme-linked immunosorbent assay for the screening of the stress state and oxytocin function. Moreover, the Depression Anxiety and Stress Scale (DASS), the Geriatric Anxiety Inventory (GAI), the Geriatric Depression Scale (GDS) and the Montgomery-Åsberg Depression Rating Scale (MADRS) were conducted to identify the severity of anxiety and depression. The association between oxytocin and mental health was performed by linear regression analyses in older patients receiving orthopedic surgery. Finally, the Duke Social Support Index (DSSI) was selected to measure the social support and the potential link to mental outcomes.

RESULTS

The scores from questionnaires showed that female patients with higher social support and higher levels of oxytocin demonstrated better stress-reducing responses as reflected by lower cortisol and decreased anxiety and depression symptoms. Regression analyses revealed that there was a significant association between oxytocin and scores in DASS, GAI, GDS, MADRS and DSSI, suggesting a potential link between peripheral oxytocin function and mood outcomes after orthopedic surgery.

CONCLUSIONS

Our findings reveal that oxytocin enhances the stress-protective effects of social support and reduces anxiety and depression states under stressful circumstances, particularly in older women receiving orthopedic surgery.

摘要

背景

研究发现,社会支持和压力管理可改善老年患者接受手术治疗后的健康结果。本研究旨在描述手术后神经精神障碍与催产素之间的关系。

方法

本研究共纳入了 132 名年龄均≥60 岁的在哈尔滨医科大学附属第一医院(哈尔滨,中国)接受骨科手术的老年患者。通过酶联免疫吸附试验检测应激激素皮质醇和催产素的唾液水平,以筛选应激状态和催产素功能。此外,采用抑郁焦虑压力量表(DASS)、老年焦虑量表(GAI)、老年抑郁量表(GDS)和蒙哥马利-阿斯伯格抑郁评定量表(MADRS)评估焦虑和抑郁的严重程度。对接受骨科手术的老年患者进行线性回归分析,以评估催产素与心理健康之间的关系。最后,采用杜克社会支持量表(DSSI)测量社会支持及其与心理健康结果的潜在联系。

结果

问卷调查评分显示,社会支持度较高、催产素水平较高的女性患者皮质醇水平较低,焦虑和抑郁症状减轻,应激反应能力更强。回归分析表明,催产素与 DASS、GAI、GDS、MADRS 和 DSSI 评分之间存在显著相关性,提示外周催产素功能与骨科手术后的情绪结果之间存在潜在联系。

结论

本研究结果表明,催产素增强了社会支持的应激保护作用,并在应激环境下减轻焦虑和抑郁状态,尤其是在接受骨科手术的老年女性中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/234e/10329356/1b6663e4abb8/12877_2023_3989_Fig1_HTML.jpg

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