过氧化物酶体增殖物激活受体-γ在老年喉癌术后谵妄患者血清中的表达  

Level of serum peroxisome proliferator-activated receptor-γ in the elderly patients with postoperative delirium after laryngectomy

作　　者：冉国 王一如 陈恺铮 沈霞 吴海涛 RAN Guo;WANG Yiru;CHEN Kaizheng;SHEN Xia;WU Haitao(Department ofAnesthesiology,Eye Ear Nose and Throat Hospital of Fudan University,Shanghai 200031,China;Department of Otorhinolaryngoloy,Eye Ear Nose and Throat Hospital of Fudan University,Shanghai 200031,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院麻醉科,上海200031 [2]复旦大学附属眼耳鼻喉科医院耳鼻喉科,上海200031

出　　处：《中国眼耳鼻喉科杂志》2020年第1期9-12,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：上海市卫生局青年基金(20154Y0144)

摘　　要：目的观察喉癌术后谵妄患者血清过氧化物酶体增殖物激活受体-γ(peroxisome proliferator-activated receptor-γ,PPAR-γ)蛋白和炎症介质表达水平的变化。方法纳入126例因喉癌在我院进行手术治疗的老年男性患者,共有18例发生术后谵妄(术后谵妄组)。以年龄和疾病累计评分作为匹配条件,共有50例未发生术后谵妄的患者进入对照组。记录2组患者术前和术后第1天的血清PPAR-γ蛋白、白细胞介素-6(IL-6)、C反应蛋白(CRP)和皮质醇水平。结果术前2组患者的血清PPAR-γ、IL-6、CRP水平差异无统计学意义(P>0.05),但术后谵妄组患者皮质醇水平高于对照组(P=0.002)。术后第1天,术后谵妄组患者血清PPAR-γ水平低于对照组(P=0.046),IL-6水平高于对照组(P<0.0001),皮质醇水平仍然高于对照组(P=0.0009),2组间CRP水平差异无统计学意义(P>0.05)。结论老年喉癌术后谵妄患者处于炎症促发状态,PPAR-γ、IL-6和皮质醇可能参与术后谵妄的发生、发展。Objective To investigate the relationship between serum peroxisome proliferator-activated receptor-γ(PPAR-γ)concentration and inflammatory markers in elderly delirious patients after laryngectomy.Methods A total of 126 elderly patients(>64 years old)diagnosed as laryngeal cancer were enrolled.Eighteen male patients developed into postoperative delirium(POD).Fifty patients without POD were matched as the control group.The matching criteria were age and cumulative illness rating scale.Serum PPAR-γ,interleukin-6(IL-6),and C-reactive protein(CRP)were assayed.The level of cortisol was also recorded.Results Preoperatively,the concentration of PPAR-γ,IL-6,and CRP were comparable between the patients with POD and without POD(P>0.05).However,the level of cortisol was higher in POD group(P=0.002).On the first postoperative day,the concentration of PPAR-γwas lower in the patients with POD(P=0.046).The IL-6 level was significantly higher in the delirious patients(55 pg/mL)than that in the control group(45 pg/mL;P<0.0001).CRP was comparable between the patients with POD and without POD.The level of cortisol was higher in the patients with POD(P=0.0009).Conclusions Elderly patients with POD show an inflammatory state.PPAR-γand IL-6,as well as cortisol,may take part in the pathogenesis of POD.

关 键 词：过氧化物酶体增殖物激活受体-Γ 喉癌 谵妄 

分 类 号：R739.65[医药卫生—肿瘤]