摘要
目的分析血清纤溶酶原激活物抑制物-1(PAI-1)、载脂蛋白A1(ApoA1)水平与老年髋或膝关节置换术患者术后谵妄(POD)及术后认知功能障碍(POCD)的相关性。方法选取2021年3月至2023年3月石家庄市第三医院收治的122例老年髋或膝关节置换术患者为研究对象,根据是否发生POD将研究对象分为POD组(发生POD,20例)和非POD组(未发生POD,102例);根据是否发生POCD将研究对象分为PCOD组(发生POCD,30例)和非POCD组(未发生POCD,92例)。比较分析非POD组与POD组患者、非POCD组与POCD组患者的临床特征。采用多因素logistic回归方法分析老年患者发生POD和POCD的影响因素。结果POD组患者的术中出血量大于非POD组,PAI-1、ApoA1均低于非POD组,差异均有统计学意义(P<0.05)。POCD组患者的文化程度为高中及以下比例高于非POCD组,PAI-1、ApoA1均低于非POCD组,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,术中出血量是老年患者发生POD的独立危险因素(P<0.05),PAI-1、ApoA1是老年患者发生POD的独立保护因素(P<0.05);文化程度为高中及以下是老年患者发生POCD的独立危险因素(P<0.05),PAI-1、ApoA1是老年患者发生POCD的独立保护因素(P<0.05)。结论PAI-1、ApoA1水平是老年髋或膝关节置换术患者发生POD、POCD的独立保护因素。
Objective To analyze the correlation analysis between serum plasminogen activator inhibitor-1(PAI-1)and apolipoprotein A1(ApoA1)levels and postoperative delirium(POD)and postoperative cognitive dysfunction(POCD)in elderly patients undergoing hip or knee arthroplasty.Method A total of 122 elderly patients undergoing hip or knee arthroplasty admitted to the Shijiazhuang Third Hospital from March 2021 to March 2023 were selected as the study subjects.According to whether POD occurred,the study subjects were divided into POD group(20 cases with POD)and non-POD group(102 cases without POD).According to whether POCD occurred,the subjects were divided into PCOD group(30 cases with POCD)and non-POCD group(92 cases without POCD).The clinical features between non-POD group and POD group,non-POCD group and POCD group were compared and analyzed.Multivariate logistic regression method was used to analyze the infl uencing factors of POD and POCD in elderly patients.Result The intraoperative blood loss in POD group was higher than that in non-POD group,and PAI-1 and ApoA1 were lower than those in non-POD group,with statistical signifi cance(P<0.05).The proportion of high school education or below in POCD group was higher than that in non-POCD group,PAI-1 and ApoA1 were lower than those in non-POCD group,with statistical signifi cance(P<0.05).Multivariate logistic regression analysis showed that intraoperative blood loss was an independent risk factor for POD in elderly patients(P<0.05),and PAI-1 and ApoA1 were independent protective factors for POD in elderly patients(P<0.05).High school education or below was an independent risk factor for POCD in elderly patients(P<0.05),and PAI-1 and ApoA1 were independent protective factors for POCD in elderly patients(P<0.05).Conclusion PAI-1 and ApoA1 levels were independent protective factors for POD and POCD in elderly patients undergoing hip or knee arthroplasty.
作者
周麟
崔倩倩
王梦茹
蒋臻
Zhou Lin;Cui Qianqian;Wang Mengru;Jiang Zhen(The second Department of anesthesia,Shijiazhuang Third Hospital,Shijiazhuang Hebei 050000,China;Operating Rooms,Shijiazhuang Third Hospital,Shijiazhuang Hebei 050000,China;Department of Traditional Chinese Medicine Orthopedics,Shijiazhuang Hebei 050000,China)
出处
《中国医刊》
CAS
2024年第9期967-970,共4页
Chinese Journal of Medicine
基金
河北省医学科学研究课题计划(20241640)。
