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术后谵妄与血浆β淀粉样蛋白寡聚体之间的关系。

The relationship between postoperative delirium and plasma amyloid beta oligomer.

作者信息

Yang YoungSoon, Jung Ki Jin, Kwak Yong Tae

机构信息

Department of Neurology, Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.

Department of Orthopaedic Surgery, Cheonan Hospital Soonchunhyang University College of Medicine, Cheonan, Korea.

出版信息

Sci Rep. 2025 Apr 16;15(1):13147. doi: 10.1038/s41598-025-97577-0.

Abstract

Postoperative delirium (POD) is a frequent complication in older people undergoing general anesthesia surgery. We investigated the potential link between Alzheimer's disease and POD by comparing plasma amyloid-beta oligomer levels (measured using the multimer detection system, MDS-OAβ) in patients who developed POD after general anesthesia surgery with those who did not. A total of 104 eligible participants were screened daily for delirium for three days postoperatively. After propensity score matching based on the ApoE4 allele, the final analysis included 31 patients with POD and 31 without POD. In the ICU, patients with delirium underwent immediate assessment with the Korean version of the Delirium Rating Scale-98 (K-DRS-98) and plasma MDS-OAβ levels. The control group (those without POD) received the same tests on the third postoperative day. Patients with POD had significantly higher MDS-OAβ values compared to those without POD. Within the POD group, MDS-OAβ values positively correlated with K-DRS-98 scores (both severity and total scores). These findings suggest an association between POD in older people undergoing general anesthesia surgery and elevated plasma amyloid oligomer levels. To definitively establish causality, further prospective studies are necessary.

摘要

术后谵妄(POD)是接受全身麻醉手术的老年人中常见的并发症。我们通过比较全身麻醉手术后发生POD的患者与未发生POD的患者的血浆淀粉样β寡聚体水平(使用多聚体检测系统MDS - OAβ测量),研究了阿尔茨海默病与POD之间的潜在联系。术后连续三天每天对总共104名符合条件的参与者进行谵妄筛查。在基于载脂蛋白E4等位基因进行倾向评分匹配后,最终分析纳入了31例发生POD的患者和31例未发生POD的患者。在重症监护病房(ICU),发生谵妄的患者立即使用韩国版谵妄评定量表98(K - DRS - 98)和血浆MDS - OAβ水平进行评估。对照组(未发生POD的患者)在术后第三天接受相同的检测。与未发生POD的患者相比,发生POD的患者的MDS - OAβ值显著更高。在POD组内,MDS - OAβ值与K - DRS - 98评分(严重程度评分和总分)呈正相关。这些发现表明,接受全身麻醉手术的老年人发生POD与血浆淀粉样寡聚体水平升高之间存在关联。为了明确建立因果关系,有必要进行进一步的前瞻性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b33/12003799/3081d897674f/41598_2025_97577_Fig1_HTML.jpg

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