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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.

DOI:10.1038/s41598-025-97577-0
PMID:40240804
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12003799/
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/a85a2eeab257/41598_2025_97577_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b33/12003799/3081d897674f/41598_2025_97577_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b33/12003799/1d1030cfba26/41598_2025_97577_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b33/12003799/a85a2eeab257/41598_2025_97577_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b33/12003799/3081d897674f/41598_2025_97577_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b33/12003799/1d1030cfba26/41598_2025_97577_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b33/12003799/a85a2eeab257/41598_2025_97577_Fig3_HTML.jpg

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本文引用的文献

1
Associations between Alzheimer's disease biomarkers and postoperative delirium or cognitive dysfunction: A meta-analysis and trial sequential analysis of prospective clinical trials.阿尔茨海默病生物标志物与术后谵妄或认知功能障碍的关联:前瞻性临床试验的荟萃分析和试验序贯分析。
Eur J Anaesthesiol. 2024 Mar 1;41(3):234-244. doi: 10.1097/EJA.0000000000001933. Epub 2023 Dec 1.
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Cerebrospinal Fluid Alzheimer's Disease Biomarker Patterns of Change Prior to the Onset of Mild Cognitive Impairment.脑脊髓液阿尔茨海默病生物标志物在轻度认知障碍发病前的变化模式。
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Prospective analysis of plasma amyloid beta and postoperative delirium in the Interventions for Postoperative Delirium: Biomarker-3 study.
术后谵妄的干预措施:生物标志物-3 研究中血浆淀粉样蛋白-β与术后谵妄的前瞻性分析。
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Integration of amyloid-β oligomerization tendency as a plasma biomarker in Alzheimer's disease diagnosis.整合淀粉样β寡聚化倾向作为阿尔茨海默病诊断中的血浆生物标志物。
Front Neurol. 2023 Jan 17;13:1028448. doi: 10.3389/fneur.2022.1028448. eCollection 2022.
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Amyloid deposition on positron emission tomography correlates with severity of perioperative delirium: a case-control pilot study.正电子发射断层扫描上的淀粉样蛋白沉积与围手术期谵妄的严重程度相关:一项病例对照试点研究。
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Advantages and disadvantages of the use of the CSF Amyloid β (Aβ) 42/40 ratio in the diagnosis of Alzheimer's Disease.使用脑脊液 Aβ(Aβ)42/40 比值诊断阿尔茨海默病的优缺点。
Alzheimers Res Ther. 2019 Apr 22;11(1):34. doi: 10.1186/s13195-019-0485-0.
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Plasma Amyloid as Prescreener for the Earliest Alzheimer Pathological Changes.血浆淀粉样蛋白作为阿尔茨海默病最早病理改变的筛查指标。
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Urol Oncol. 2018 Jul;36(7):341.e15-341.e22. doi: 10.1016/j.urolonc.2018.04.012. Epub 2018 May 24.