首页|术前IL-17A、CAR联合检测对老年患者全麻术后谵妄的预测价值

术前IL-17A、CAR联合检测对老年患者全麻术后谵妄的预测价值

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目的 分析术前白介素-17A(IL-17A),C-反应蛋白/白蛋白比值(CAR)联合检测对老年患者全麻术后谵妄的预测价值.方法 分析2022年7月至2023年6月于北京市通州妇幼保健院接受全麻手术的老年患者283例作为研究对象,并依据术后谵妄发生情况将其分为谵妄组(n=74)与非谵妄组(n=209).收集两组患者的一般资料、术前实验室指标,进行单因素、多因素Logistic回归分析,分析老年患者全麻术后谵妄的影响因素.并绘制受试者工作特征(ROC)曲线分析术前IL-17A、CAR联合检测对老年患者全麻术后谵妄的预测效能.结果 老年全麻术后发生谵妄与未发生谵妄患者年龄、复苏时间、术中出血量、ASA分级、有无饮酒史、ASA分级、有无使用镇静药、血清白蛋白、Hb、IL-17A、CRP及CAP水平比较差异具有统计学意义(x2/t=2.134、3.535、6.608、8.944、4.679、11.097、5.786、2.086、6.409、17.066、13.946,P<0.05).多因素Logistic回归分析结果显示,年龄、术中出血量、有无使用镇静剂、血清白蛋白、IL-17A、CRP、CAP水平为老年患者全麻术后是否发生谵妄的影响因素(P<0.05).ROC曲线结果显示,IL-17A、CAP、联合预测曲线下面积(AUC)分别为0.871、0.959、0.984(P<0.05),敏感度分别为0.716、0.932、0.959,特异性分别为0.837、0.880、0.943.结论 术前IL-17A与CAP水平影响老年患者全麻术后谵妄的发生,单项及联合检测均对老年患者全麻术后谵妄具有良好的预测效能.
Predictive value of preoperative IL-17A and CAR combined detection for delirium in elderly patients after general anesthesia
Objective To analyze the predictive value of preoperative interleukin-17A(IL-17A) and C-reactive protein/albumin ratio(CAR)for postoperative delirium in elderly patients under general anesthesia. Methods A total of 283 elderly patients who underwent general anesthesia surgery at Beijing Tongzhou Maternal and Child Health Hospital from July 2022 to June 2023 were retrospectively analyzed. They were divided into two groups based on the occurrence of postoperative delirium:the delirium group(n=74) and the non-delirium group (n=209). The general data and preoperative laboratory indexes of both groups were collected. Univariate and multivariate logistic regression analysis were conducted to analyze the factors influencing delirium in elderly patients after general anesthesia. The receiver operating characteristic (ROC) curves were drawn to analyze the predictive efficacy of preoperative IL-17A and CAR combined detection for delirium after general anesthesia in elderly patients. Results There were significant differences in age,resuscitation time,intraoperative blood loss,ASA grade,alcohol history,sedative drug use,serum albumin,Hb, IL-17A,CRP and CAP levels between the elderly patients with delirium after general anesthesia and those without delirium(x2/t=2.134,3.535,6.608,8.944,4.679,11.097,5.786,2.086,6.409,17.066,13.946, P<0.05). Multivariate logistic regression analysis showed that age,intraoperative blood loss,sedative use or not,serum albumin,IL-17A,CRP and CAP levels were the influencing factors for delirium after general anesthesia in elderly patients(P<0.05). The ROC curve results showed that IL-17A,CAP and AUC were 0.871, 0.959 and 0.984(P<0.05). The sensitivity was 0.716,0.932 and 0.959,and the specificity was 0.837,0.880 and 0.943,respectively. Conclusion Preoperative levels of IL-17A and CAP affect the occurrence of delirium in elderly patients after general anesthesia. Both single and combined detection show good predictive efficacy for delirium in elderly patients after general anesthesia.

IL-17ACARElderly patientsDelirium after surgery under general anesthesia

金晓莉、沈启云、冯玉静、赵静文

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北京市通州区妇幼保健院麻醉科,北京101100

白介素-17A C-反应蛋白/白蛋白比值 老年患者 全麻手术后谵妄

北京市通州区科技计划

KJ2020CX011

2024

分子诊断与治疗杂志
中山大学

分子诊断与治疗杂志

CSTPCD
影响因子:0.65
ISSN:1674-6929
年,卷(期):2024.16(2)
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