摘要
目的分析血清糖原合成酶激酶-3β(GSK-3β)、沉默信息调节因子1(SIRT1)水平对体外循环心脏手术患者术后认知功能障碍(POCD)的预测价值。方法回顾性分析2020年10月-2022年11月在本院接受体外循环心脏手术的120例患者的临床资料,按照MoCA、MMSE量表评分结果将其分为POCD组(47例)与非POCD组(73例)。评估2组术前术后认知功能,检测术前术后血清GSK-3β、SIRT1水平。Pearson相关性分析血清GSK-3β、SIRT1水平与POCD的关系;受试者工作曲线(ROC)分析血清CSK-3β、SIRT1水平对POCD的预测价值。结果POCD发生率为39.17%(43/120),术后POCD组MoCA、MMSE评分以及血清SIRT1水平显著低于非POCD组,血清CSK-3β水平显著高于非POCD组(P<0.05)。Pearson相关性分析结果显示,血清GSK-3β水平与MoCA、MMSE评分成负相关关系(r值分别为-0.454、-0.436,P均<0.001),血清SIRT1水平与MoCA、MMSE评分成正相关关系(r值分别为0.665、0.605,P均<0.001)。ROC曲线显示,血清GSK-3β、SIRT1水平及联合检测用于预测POCD的敏感度分别为67.19%、73.13%、67.16%;特异度分别为83.02%、67.92%、86.79%;AUC分别为0.806、0.713、0.813。结论体外循环心脏手术后POCD患者血清CSK-3β水平显著升高,血清SIRT1水平显著降低,且血清GSK-3β、SIRT1水平与POCD均具有相关性,对POCD具有一定预测价值,联合检测预测价值更高。
Objective This paper aims to analyze the predictive value of serum glycogen synthetase kinase-3β(GSK-3β)and silence-information regulatory factor 1(SIRT1)levels on postoperative cognitive dysfunction(POCD)in patients with car-diopulmonary bypass(CPB)heart surgery.Methods The clinical data of 120 patients who received cardiopulmonary bypass heart surgery in our hospital from October 2020 to November 2022 were retrospectively analyzed and divided into POCD group(47 cases)and non-POCD group(73 cases)according to the scores of MoCA and MMSE.The cognitive function of the two groups was evaluated before and after operation,and the serum levels of GSK-3βand SIRTI were detected before and after operation.Pearson correlation analysis was performed to determine the relationship between serum GSK-3β,SIRT1 levels and POCD.The predictive value of serum GSK-3βand SIRT1 levels to POCD was analyzed by receiver operating curve(ROC).Results The incidence of POCD was 39.17%(43/120).The score of MoCA,MMSE and serum SIRT1 in POCD group were significantly lower than those in non-POCD group,and the serum GSK-3βlevel was significantly higher than that in non-POCD group(P<0.05).Pearson correlation analysis showed that serum GSK-3βlevel was negatively correlated with MoCA and MMSE scores(r=-0.454,r=-0.436,P<0.001),and serum SIRT1 level was positively correlated with MoCA and MMSE scores(r=0.665,r=0.605,P<0.001).ROC curve showed that the levels of serum GSK-3βand SIRT1 and the sensitivity of combined detection to predict POCD were 67.19%,73.13%and 67.16%,respectively.The specificity was 83.02%,67.92%,86.79%,respectively.The AUCs were 0.806,0.713 and 0.813,respectively.Conclusion Serum GSK-3βlevel is significantly increased and serum SIRTI level is significantly decreased in patients with POCD fter cardiopulmonary bypass heart surgery,and serum GSK-3βand SIRTI levels are correlated with POCD,which has a certain predictive value for POCD,and the combined detection has a higher predictive value.
作者
唐智豪
熊畅
彭文勇
TANG Zhi-hao;XIONG Chang;PENG Wen-yong(Department of Anesthesia,Jinhua Central Hospital,Zhejiang 321000,China)
出处
《中国卫生检验杂志》
CAS
2023年第22期2753-2756,2789,共5页
Chinese Journal of Health Laboratory Technology
基金
2022年度金华市第二批重大(重点)科技计划项目(2022-3-094)。
