Wei Lai, Zhu Xiaoyu, Zhao Yiming, Zou Yi, Hu Tao, Huang Qian, Li Jieqiong, Pan Bingbing, Kong Gaoyin, Tan Siyou, Chen Wenyan
Department of Anesthesiology, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China.
Perioperative Enhanced Recovery Anesthesia Clinical Medical Research Center of Hunan Province, Changsha, China.
Front Neurol. 2025 Apr 16;16:1537780. doi: 10.3389/fneur.2025.1537780. eCollection 2025.
Elderly surgical patients are at high risk of perioperative sleep disturbances (PSD), and the underlying pathogenic mechanisms remain unclear. The relationship between peripheral inflammatory status and PSD pathogenesis currently lacks substantial clinical evidence.
This study aims to evaluate the association between peripheral inflammation indicators and PSD in elderly patients undergoing laparoscopic hepatobiliary surgery, and to analyze the dynamic changes in peripheral inflammation in PSD patients throughout the perioperative period.
Using retrospective data, this study compares peripheral inflammatory markers (NLR, MLR, PLR, SII, IL-6, and IL-10) in patients with PSD vs. those with normal sleep patterns before and after surgery. Receiver operating characteristic (ROC) curves were employed to evaluate the discriminative power of these indicators for PSD. Logistic regression models were employed to assess risk associations between inflammatory markers and PSD. Dynamic changes in peripheral inflammation were compared before surgery, on the day the surgery ended, and 1 day post-surgery between patients with PSD and those with normal sleep, exploring potential correlations with PSD pathogenesis.
The study ultimately included clinical data from 156 patients. Findings indicated that elevated NLR and SII levels before and after surgery, alongside decreased plasma IL-10 levels post-surgery, are associated with a higher incidence of PSD. Peripheral inflammatory markers on the day of surgery were not significantly predictive of post-PSD. Multivariable logistic regression analyses identified NLR, SII, IL-6, and IL-10 as independent predictors of pre-PSD, while NLR, SII, and IL-10 remained independently associated with post-PSD.
Dynamic changes in peripheral inflammation during the perioperative period are associated with PSD in elderly patients undergoing laparoscopic hepatobiliary surgery. These findings may support the early identification and screening of high-risk PSD patients, providing new insights into the underlying mechanisms of PSD pathogenesis.
老年外科患者围手术期睡眠障碍（PSD）风险较高，其潜在致病机制尚不清楚。目前外周炎症状态与PSD发病机制之间的关系缺乏充分的临床证据。
本研究旨在评估老年腹腔镜肝胆手术患者外周炎症指标与PSD之间的关联，并分析PSD患者围手术期外周炎症的动态变化。
本研究利用回顾性数据，比较了PSD患者与术前术后睡眠模式正常患者的外周炎症标志物（NLR、MLR、PLR、SII、IL-6和IL-10）。采用受试者工作特征（ROC）曲线评估这些指标对PSD的判别能力。采用逻辑回归模型评估炎症标志物与PSD之间的风险关联。比较PSD患者和睡眠正常患者术前、手术结束当天和术后1天外周炎症的动态变化，探索与PSD发病机制的潜在相关性。
本研究最终纳入了156例患者的临床数据。结果表明，术前术后NLR和SII水平升高，以及术后血浆IL-10水平降低，与PSD的发生率较高相关。手术当天的外周炎症标志物对术后PSD的预测作用不显著。多变量逻辑回归分析确定NLR、SII、IL-6和IL-10为术前PSD的独立预测因素，而NLR、SII和IL-10仍然与术后PSD独立相关。
围手术期外周炎症的动态变化与老年腹腔镜肝胆手术患者的PSD相关。这些发现可能有助于早期识别和筛查PSD高危患者，为PSD发病机制的潜在机制提供新的见解。
