中国现代普通外科进展2024,Vol.27Issue(8) :613-617.DOI:10.3969/j.issn.1009-9905.2024.08.005

术中rSO2联合血清CHI3L1、CXCL16对结直肠癌患者术后认知功能障碍的预测价值

Predictive value of intraoperative rSO2 combined with se-rum CHI3L1 and CXCL16 for postoperative cognitive im-pairment in patients with colorectal cancer

刘定国 马改改 任莹莹 崔俊飞 钱晓岚
中国现代普通外科进展2024,Vol.27Issue(8) :613-617.DOI:10.3969/j.issn.1009-9905.2024.08.005

术中rSO2联合血清CHI3L1、CXCL16对结直肠癌患者术后认知功能障碍的预测价值

Predictive value of intraoperative rSO2 combined with se-rum CHI3L1 and CXCL16 for postoperative cognitive im-pairment in patients with colorectal cancer

刘定国 1马改改 1任莹莹 1崔俊飞 2钱晓岚
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作者信息

  • 1. 河南省直第三人民医院麻醉手术部(河南 郑州 450006)
  • 2. 河南省直第三人民医院胃肠外科(河南 郑州 450006)
  • 折叠

摘要

目的:探讨术中脑氧饱和度(rSO2)联合血清几丁质酶3类蛋白1(CHI3L1)、CXC型趋化因子配体16(CXCL16)对结直肠癌患者术后认知功能障碍(POCD)的预测价值.方法:选取2021年11月至2023年9月我院行结直肠癌术后发生POCD的83例患者作为研究组,另选取同期行结直肠癌术后无POCD的83例患者作为对照组.采用Spearman法分析血清CHI3L1、CXCL16表达水平与MMSE评分的相关性;采用受试者工作特征(ROC)曲线分析术中rSO2联合血清CHI3L1、CXCL16对结直肠癌患者术后POCD的预测价值.结果:研究组与对照组术后简易精神状态评价量表(MMSE)评分存在显著性差异(P<0.05);两组T0和T1时间点rSO2水平比较,差异无统计学意义(P>0.05),T2、T3、T4及T5时间点rSO2水平存在显著性差异(P<0.05),且研究组rSO2变化率高于对照组(P<0.05);研究组血清CHI3L1和CXCL16表达水平均高于对照组(P<0.05);血清CHI3L1、CXCL16表达水平及术中rSO2变化率均与MMSE评分呈负相关(P<0.05);血清CH I3L1、CXCL16水平及rSO2变化率单独预测结直肠癌患者术后POCD的曲线下面积(AUC)分别为0.790、0.754及0.870,而三者联合预测的AUC为0.944,优于各自单独预测(Z三者联合-CHI3L1=4.742、Z三者联合-CXCL16=5.081,Z三者联合-rSO2变化率=2.986,P均<0.05).结论:术中rSO2联合血清CHI3L1、CXCL16对结直肠癌患者术后POCD具有较高的预测效能.

Abstract

Objective:To explore the predictive value of intraoperative cerebral oxygen satu-ration(rSO2)combined with serum chitinase-3-like protein 1(CHI3L1)and CXC-chemokine ligand 16(CXCL16)for postoperative cognitive dysfunction(POCD)in colorectal cancer patients.Meth-ods:83 patients who developed POCD after colorectal cancer surgery in our hospital from Novem-ber 2021 to September 2023 were selected as the study group,another 83 patients without POCD who underwent colorectal cancer surgery were as control group.Spearman method was applied to analyze the correlation between serum CHI3L1,CXCL16 expression levels and MMSE score;re-ceiver operating characteristic(ROC)curve was applied to analyze the predictive value of intraopera-tive rSO2 combined with serum CHI3L1 and CXCL16 for postoperative POCD in colorectal cancer patients.Results:There was statistically difference in the postoperative MMSE scores between the study group and the control group(P<0.05);there was no statistically difference in rSO2 level between the two groups at T0 and T1 time points(P>0.05),while there was statistically difference in rSO2 level at T2,T3,T4,and T5 time points(P<0.05),and the change rate of rSO2 in the study group was higher than that in the control group(P<0.05);the expression levels of serum CHI3L1 and CXCL16 in the study group were higher than those in the control group(P<0.05);the expres-sion levels of serum CHI3L1 and CXCL16,and the intraoperative change rate of rSO2 were nega-tively correlated with MMSE score(P<0.05);the area under the curve(AUC)of serum CHI3L1,CXCL16 levels,and rSO2 change rate alone for predicting postoperative POCD in colorectal cancer patients was 0.790,0.754,and 0.870,respectively,however,the AUC predicted by the combina-tion of the three was 0.944,which was better than their individual predictions(Zcombination-CHI3L1=4.742,Zcombination-XCL16=5.081,Zcombination-rSO2 change rate=2.986,P<0.05).Conclusion:The combination of intraop-erative rSO2 and serum CHI3L1 and CXCL16 expression have high predictive efficacy for postop-erative POCD in colorectal cancer patients.

关键词

结直肠肿瘤/外科治疗/脑氧饱和度/认知功能障碍/几丁质酶3类蛋白1/CXC型趋化因子配体16

Key words

Colorectal tumors/Surgical treatment/Cerebral oxygen saturation/Cognitive im-pairment/Chitinase class 3 protein 1/CXC-chemokine ligand

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基金项目

河南省医学科技攻关计划联合共建项目(LHGJ20190018)

出版年

2024
中国现代普通外科进展
山东大学

中国现代普通外科进展

CSTPCD
影响因子:0.993
ISSN:1009-9905
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