β2微球蛋白与膝关节或髋关节置换术后谵妄及3年死亡率的相关性：一项前瞻性队列研究。

Correlation of β2-microglobulin with postoperative delirium and 3-year mortality undergoing knee or hip replacement surgery: a prospective cohort study.

作者信息

Wang Yuanlong, He Qian, Fu Kun, Bi Yanlin, Wang Bin, Kong Wenjie, Hua Shuhui, Kong Jian, Xu Shanling, Gong Hongyan, Wang Jiahan, Li Chuan, Lin Yanan, Lin Xu

机构信息

Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, China.

Second Clinical Medical College, Binzhou Medical University, Yantai, China.

出版信息

Front Med (Lausanne). 2025 Aug 5;12:1597764. doi: 10.3389/fmed.2025.1597764. eCollection 2025.

DOI:10.3389/fmed.2025.1597764

PMID:40837565

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12361206/

Abstract

INTRODUCTION

Postoperative delirium (POD) is a commonly occurring condition in the postoperative period. Therefore, the study intends to investigate the relationship between BM and POD and the effect of BM levels on three-year postoperative mortality in patients with POD.

METHODS

Postoperatively, the Confusion Assessment Method (CAM) and the Monumental Delirium Assessment Scale (MDAS) were used to assess the incidence and severity of POD. Preoperative plasma BM levels were measured utilizing a latex-enhanced immunoturbidimetric assay. Total tau protein (T-tau), phosphorylated tau protein (P-tau), and amyloid β plaque 42 (Aβ) were detected in preoperative cerebrospinal fluid (CSF) by enzyme-linked immunosorbent assay. Logistic regression equations were applied to examine the risk factors linked to POD. Patients presenting with POD were grouped according to BM level and followed up for 3 years postoperatively for their survival and Kaplan-Meier survival curves were plotted.

RESULTS

The prevalence of POD was 7.23%. Serum BM levels were higher in POD patients compared to non-POD (NPOD) patients ( = 0.01). The results of the logistic regression analysis indicated that BM ( = 1.394,  = 1.017-1.910,  = 0.002) and T-tau ( = 1.006,  = 1.002-1.011, 0.007) posed a risk for POD. BM and POD were partially associated through the mediation of CSF T-tau (10.0%). The K-M survival curves showed that patients with high BM who developed POD had a higher mortality rate 3 years after surgery ( = 0.031).

CONCLUSION

In summary, BM may be a risk factor for POD, which might be mediated in part by CSF T-tau.

摘要

引言

术后谵妄（POD）是术后常见的一种情况。因此，本研究旨在探讨脑微管相关蛋白（BM）与POD之间的关系以及BM水平对POD患者术后三年死亡率的影响。

方法

术后，采用意识模糊评估法（CAM）和重症谵妄评估量表（MDAS）评估POD的发生率和严重程度。术前血浆BM水平采用乳胶增强免疫比浊法测定。术前脑脊液（CSF）中总tau蛋白（T-tau）、磷酸化tau蛋白（P-tau）和淀粉样β斑块42（Aβ）通过酶联免疫吸附测定法检测。应用逻辑回归方程检验与POD相关的危险因素。出现POD的患者根据BM水平分组，并在术后随访3年观察其生存情况，绘制Kaplan-Meier生存曲线。

结果

POD的患病率为7.23%。与非POD（NPOD）患者相比，POD患者的血清BM水平更高（P = 0.01）。逻辑回归分析结果表明，BM（P = 1.394，95%CI = 1.017 - 1.910，P = 0.002）和T-tau（P = 1.006，95%CI = 1.002 - 1.011，P = 0.007）是POD的危险因素。BM与POD通过CSF T-tau的介导存在部分关联（10.0%）。K-M生存曲线显示，发生POD的高BM患者术后3年死亡率更高（P = 0.031）。