妇科肿瘤患者腹腔镜术后谵妄预测的生物标志物分析

发布时间：2018-06-03 16:35

本文选题：谵妄 + 中性粒细胞明胶酶相关脂质运载蛋白　；参考：《中国内镜杂志》2017年09期

【摘要】：目的探讨血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)与S-100β蛋白对妇科肿瘤患者腹腔镜术后谵妄(POD)的预测效果。方法选取2015年3月-2016年6月该院收治的256例行腹腔镜全麻手术的妇科肿瘤患者为研究对象,根据术后状况分为POD组(n=31)和非POD组(n=225)。比较两组的全麻前5 min、气管拔管即刻、出麻醉后监测治疗室(PACU)前、术后24、48和72 h的血清NGAL、S-100β蛋白、肌酐(Scr)和胱抑素C(Cys-c)的水平。采用受试者工作曲线下面积(AUC)来评价各指标对POD的预测效果。结果两组全麻后的血清NGAL与S-100β的水平均明显高于全麻前,差异有统计学意义(P0.05)。POD组的气管拔管即刻、出PACU前、术后24 h的血清NGAL水平明显高于非POD组,差异有统计学意义(P0.05);POD组的气管拔管即刻、出PACU前、术后24、48和72 h的血清S-100β水平明显高于非POD组,差异有统计学意义(P0.05)。全部患者术后均未出现急性肾损伤(AKI),两组不同时间点的血清Scr与Cys-C水平比较,差异均无统计学意义(P0.05)。气管拔管即刻、出PACU前、术后24 h的血清NGAL与S-100β的AUC分别为0.75、0.77、0.66和0.85、0.83、0.80(P0.05)。结论血清NGAL和S-100β水平可作为妇科肿瘤患者腹腔镜术后谵妄的早期预测指标,且后者的预测效果更加好,尤其是气管拔管即刻与出PACU前。
[Abstract]:Objective to investigate the predictive effect of serum neutrophil gelatinase-associated lipid carrier protein (NGALs) and S-100 尾 protein on delirium POD in patients with gynecological neoplasms after laparoscopic surgery. Methods from March 2015 to June 2016, 256 patients with gynecologic neoplasms undergoing laparoscopic general anesthesia were divided into two groups: POD group (n = 31) and non-POD group (n = 225). The serum levels of NGALS-100 尾, creatinine Scr) and cystatin Cys-c were compared between the two groups 5 min before general anesthesia, 5 min before tracheal extubation, 24 h after anesthesia, 24 h after operation, and 72 h after the extubation of PACUU, and the serum levels of NGALS-100 尾, creatinine (creatinine) and cystatin Cys-c (Cys-c) were measured. The area under the operating curve was used to evaluate the predictive effect of each index on POD. Results the levels of serum NGAL and S-100 尾 in the two groups after general anesthesia were significantly higher than those before general anesthesia, and the difference was statistically significant. The serum NGAL levels were significantly higher in the P0.05U 路POD group than in the non-POD group at 24 hours before and 24 hours after PACU extubation. The serum S-100 尾 levels in the P0.05 / POD group were significantly higher than those in the non-POD group (P 0.05) immediately after tracheal extubation and 24 h and 72 h after PACU, and the difference was statistically significant (P 0.05). No acute renal injury was found in all the patients. There was no significant difference in serum Scr and Cys-C levels between the two groups at different time points (P 0.05). Immediately after tracheal extubation, 24 hours after PACU, the AUC of serum NGAL and S-100 尾 were 0.75U 0.77U 0.66 and 0.85U 0.83U 0.80 P0.05, respectively. Conclusion Serum levels of NGAL and S-100 尾 can be used as early predictors of delirium in patients with gynecological neoplasms after laparoscopic surgery, and the latter is more effective in predicting delirium, especially immediately after tracheal extubation and before PACU.
【作者单位】：华中科技大学同济医学院附属武汉中心医院妇科;
【分类号】：R737.3

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