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首页> 外文期刊>Journal of neuroinflammation >Preoperative cerebrospinal fluid cytokine levels and the risk of postoperative delirium in elderly hip fracture patients
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Preoperative cerebrospinal fluid cytokine levels and the risk of postoperative delirium in elderly hip fracture patients

机译：老年髋部骨折患者术前脑脊液细胞因子水平和术后del妄的风险

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Background Aging and neurodegenerative disease predispose to delirium and are both associated with increased activity of the innate immune system resulting in an imbalance between pro- and anti-inflammatory mediators in the brain. We examined whether hip fracture patients who develop postoperative delirium have altered levels of inflammatory mediators in cerebrospinal fluid (CSF) prior to surgery. Methods Patients were 75 years and older and admitted for surgical repair of an acute hip fracture. CSF samples were collected preoperatively. In an exploratory study, we measured 42 cytokines and chemokines by multiplex analysis. We compared CSF levels between patients with and without postoperative delirium and examined the association between CSF cytokine levels and delirium severity. Delirium was diagnosed with the Confusion Assessment Method; severity of delirium was measured with the Delirium Rating Scale Revised-98. Mann–Whitney U tests or Student t-tests were used for between-group comparisons and the Spearman correlation coefficient was used for correlation analyses. Results Sixty-one patients were included, of whom 23 patients (37.7%) developed postsurgical delirium. Concentrations of Fms-like tyrosine kinase-3 (P=0.021), Interleukin-1 receptor antagonist (P=0.032) and Interleukin-6 (P=0.005) were significantly lower in patients who developed delirium postoperatively. Conclusions Our findings fit the hypothesis that delirium after surgery results from a dysfunctional neuroinflammatory response: stressing the role of reduced levels of anti-inflammatory mediators in this process. Trial registration The Effect of Taurine on Morbidity and Mortality in the Elderly Hip Fracture Patient. Registration number: NCT00497978. Local ethical protocol number: NL16222.094.07.
机译：背景衰老和神经退行性疾病易患ir妄，并且都与先天免疫系统活性增强有关，导致大脑中促炎和抗炎介质之间的失衡。我们检查了发生ir妄的髋部骨折患者在手术前是否改变了脑脊液（CSF）中的炎症介质水平。方法患者年龄在75岁以上，接受外科手术治疗急性髋部骨折。术前收集脑脊液样品。在一项探索性研究中，我们通过多元分析测量了42种细胞因子和趋化因子。我们比较了有和没有术后ir妄的患者的CSF水平，并检查了CSF细胞因子水平与del妄严重程度之间的关系。 r妄被诊断为混淆评估法; the妄的严重程度用《 Delirium Rating Scale Revised-98》进行了测量。组间比较使用Mann–Whitney U检验或Student t检验，而Spearman相关系数用于相关性分析。结果共纳入61例患者，其中23例（37.7％）出现developed妄。术后出现del妄的患者中Fms样酪氨酸激酶3（P = 0.021），白细胞介素1受体拮抗剂（P = 0.032）和白细胞介素6（P = 0.005）的浓度显着降低。结论我们的发现符合以下假说，即after妄是由功能失调的神经炎症反应导致的：强调在这一过程中降低抗炎介质水平的作用。试验注册牛磺酸对老年髋部骨折患者的发病率和死亡率的影响。注册号：NCT00497978。本地道德协议编号：NL16222.094.07。

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