Guo Zongfeng, Zhang Chen, Wang Xiang, Chen Weiguo, Guo Zongxiao
Anesthesiology Department, Hai 'an People's Hospital Affiliated to Nantong University, Hai'an, China.
Central Laboratory, Hai 'an People's Hospital Affiliated to Nantong University, Hai'an, China.
Brain Behav. 2025 May;15(5):e70436. doi: 10.1002/brb3.70436.
To investigate the relationship between soluble platelet-derived growth factor β receptor (sPDGFRβ) in cerebrospinal fluid (CSF) and Alzheimer's disease (AD) biomarkers, to determine whether high CSF sPDGGFRβ is a potential risk factor for postoperative delirium (POD), and to evaluate its predictive effect, so as to provide reference for clinical prevention and treatment.
CSF samples were collected preoperatively from cognitively normal participants aged 50-90 years undergoing knee/hip replacement surgery under spinal-epidural anesthesia. The concentrations of sPDGFRβ, β-amyloid 42 (Aβ42), total tau protein (Ttau), and phosphorylated tau protein (Ptau) in CSF were detected by enzyme-linked immunosorbent assay (ELISA). The confusion assessment method (CAM) was used to evaluate whether participants developed POD after surgery, and they were divided into the POD group and non-POD group (NPOD). The relationship between CSF sPDGFRβ, AD biomarkers, and POD was analyzed.
The level of sPDGFRβ, a marker of brain pericyte injury, was significantly increased in POD patients (p < 0.05), and the difference was still statistically significant after adjusting for multiple confounders (p < 0.05). CSF Aβ42 showed a significant mediating effect between CSF sPDGFRβ level and POD (22.45%). The combination of AD biomarkers and CSF sPDGFRβ predicted POD better than that of AD biomarkers or CSF sPDGFRβ alone.
The results suggest that the increase in CSF sPDGFRβ is associated with an increased risk of POD due to the blood-brain barrier (BBB) dysfunction and reduced Aβ42 clearance. In this study, the correlation between CSF sPDGFRβ and POD was investigated for the first time, providing a new reference index for POD prediction. However, this paper did not study other relevant indicators of the BBB and lacked follow-up, which could be further improved in the future.
探讨脑脊液（CSF）中可溶性血小板衍生生长因子β受体（sPDGFRβ）与阿尔茨海默病（AD）生物标志物之间的关系，确定脑脊液中高浓度的sPDGGFRβ是否是术后谵妄（POD）的潜在危险因素，并评估其预测作用，为临床防治提供参考。
术前从50 - 90岁认知正常、接受腰麻 - 硬膜外联合麻醉下行膝关节/髋关节置换手术的参与者中采集脑脊液样本。采用酶联免疫吸附测定（ELISA）法检测脑脊液中sPDGFRβ、β - 淀粉样蛋白42（Aβ42）、总tau蛋白（Ttau）和磷酸化tau蛋白（Ptau）的浓度。采用意识模糊评估法（CAM）评估参与者术后是否发生POD，并将其分为POD组和非POD组（NPOD）。分析脑脊液sPDGFRβ、AD生物标志物与POD之间的关系。
POD患者脑周细胞损伤标志物sPDGFRβ水平显著升高（p < 0.05），在调整多个混杂因素后差异仍具有统计学意义（p < 0.05）。脑脊液Aβ42在脑脊液sPDGFRβ水平与POD之间显示出显著的中介作用（22.45%）。AD生物标志物与脑脊液sPDGFRβ联合预测POD的效果优于单独使用AD生物标志物或脑脊液sPDGFRβ。
结果表明，脑脊液sPDGFRβ升高与血脑屏障（BBB）功能障碍和Aβ42清除减少导致的POD风险增加有关。本研究首次探讨了脑脊液sPDGFRβ与POD之间的相关性，为POD预测提供了新的参考指标。然而，本文未研究血脑屏障的其他相关指标且缺乏随访，未来可进一步改进。
