神经损伤生物标志物与术后谵妄相关性的Meta分析  

Correlation between biomarkers of nerve injury and postoperative delirium:a meta-analysis

作　　者：杨飞 修萌 王清秀[2] 王晨威 张美洁 张伟英[3] YANG Fei;XIU Meng;WANG Qingxiu;WANG Chenwei;ZHANG Meijie;ZHANG Weiying(School of Medicine,Tongji University,Shanghai 200070,China)

机构地区：[1]同济大学医学院,上海市200070 [2]同济大学附属东方医院麻醉科 [3]同济大学附属东方医院护理部

出　　处：《临床麻醉学杂志》2025年第4期401-408,共8页Journal of Clinical Anesthesiology

基　　金：上海市浦东新区卫生系统领先人才培养计划(PWRl2020-10);上海市浦东新区卫生系统重要薄弱学科建设项目资助(PWZbr2022-04);同济大学医学院学科建设三年行动计划重点学科项目(JS2210103)。

摘　　要：目的系统分析神经损伤生物标志物与术后谵妄(POD)的相关性。方法计算机检索中国知网、万方、维普、中国生物医学文献、PubMed、Web of Science、Scopus、Cochrane Library数据库,纳入关于POD术前神经损伤生物标志物的研究,检索时间为建库至2024年1月,采用Stata 17.0软件对数据进行Meta分析。结果共纳入30篇文献,患者6858例,其中POD组1703例,非POD组5128例。Meta分析结果显示,神经损伤标志物中Aβ40(SMD=0.68,95%CI 0.06~1.31,P=0.001)、T-tau(SMD=0.72,95%CI 0.43~1.01,P<0.001)、p-tau(SMD=1.17,95%CI 0.59~1.75,P<0.001)、NfL(SMD=0.50,95%CI 0.28~0.71,P<0.001)与POD呈正相关,Aβ42(SMD=-0.71,95%CI-0.97~-0.44,P<0.001)、Aβ40/p-tau(SMD=-0.83,95%CI-1.40~-0.25,P=0.005)、Aβ40/T-tau(SMD=-0.96,95%CI-1.45~-0.45,P<0.001)、Aβ42/p-tau(SMD=-0.97,95%CI-1.31~-0.64,P<0.001)、Aβ42/T-tau(SMD=-0.96,95%CI-1.30~-0.62,P<0.001)、Aβ42/Aβ40(SMD=-1.13,95%CI-1.52~-0.74,P<0.001)与POD呈负相关。结论Aβ40、Aβ42、T-tau、p-tau、NfL、Aβ40/p-tau、Aβ40/T-tau、Aβ42/p-tau、Aβ42/T-tau、Aβ42/Aβ40是POD术前神经损伤生物标志物,可用于构建POD预测模型。Objective To systematically analyze the correlation between biomarkers of nerve injury and postoperative delirium(POD).Methods Studies related to POD neural injury biomarkers published in CNKI,Wanfang database,VIP database,Chinese Biomedical Literature database,PubMed,Web of Science,Scopus,and the Cochrane Library were searched.The search period was from the establishment of the database to January,2024.Stata 17.0 software was used for meta-analysis of the data.Results A total of 30 articles were included,including 6858 patients.There were 1703 patients in POD group and 5128 patients in non-POD group.The results of meta-analysis showed that the markers of nerve damage in Aβ40(SMD=0.68,95%CI 0.06 to 1.31,P=0.032),T-tau(SMD=0.72,95%CI 0.43 to 1.01,P<0.001),p-tau(SMD=1.17,95%CI 0.59 to 1.75,P<0.001),NfL(SMD=0.50,95%CI 0.28 to 0.71,P<0.001)were positively correlated with POD.Aβ42(SMD=-0.71,95%CI-0.97 to-0.44,P<0.001),Aβ40/p-tau(SMD=-0.83,95%CI-1.40 to-0.25,P=0.005),Aβ40/T-tau(SMD=-0.96,95%CI-1.45 to-0.45,P<0.001),Aβ42/p-tau(SMD=-0.97,95%CI-1.31 to-0.64,P<0.001),Aβ42/T-tau(SMD=-0.96,95%CI-1.30 to-0.62,P<0.001),Aβ42/Aβ40(SMD=-1.13,95%CI-1.52 to-0.74,P<0.001)were negatively correlated with POD.Conclusion Aβ40,Aβ42,T-tau,p-tau,NfL,Aβ40/p-tau,Aβ40/T-tau,Aβ42/p-tau,Aβ42/T-tau,and Aβ42/Aβ40 could be preoperative the neurological injury biomarkers of POD.These biomarkers can be used to construct a prediction model of POD.

关 键 词：术后谵妄 生物标志物 神经损伤 META分析 

分 类 号：R614[医药卫生—麻醉学]