Abstract：Objective: To investigate the predictive value of serum interleukin-17A (IL-17A) and orexin A (OXA) for postoperative cognitive dysfunction in elderly patients of hip fracture undergoing general anesthesia and analyze the influencing factors. Methods: A total of 185 elderly patients of hip fracture undergoing general anesthesia were selected as the research subjects. According to their postoperative cognitive dysfunction, they were divided into cognitive dysfunction group (POCD group, 51 cases) and non-cognitive dysfunction group (NPOCD group, 134 cases). The serum levels of IL-17A and OXA were detected by ELISA. The receiver operating characteristic (ROC) curve were used to analyze the predicting value of serum IL-17A and OXA levels on POCD, and multivariate logistic regression analysis was used to analyze the influencing factors of POCD. Results: The levels of IL-17A and OXA in the two groups were significantly higher than those before operation (P<0.01). The level of OXA in POCD group was significantly higher than that in NPOCD group (P<0.01), while the level of OXA in POCD group was lower than that in NPOCD group (P<0.01). The ROC curve analysis showed that the cutoff values of serum IL-17A and OXA for POCD prediction were 33.96 ng/ml and 249.70 pg/ml, respectively, and AUC were 0.843 and 0.799, respectively. The logistic regression analysis showed that age, preoperative complications≥3, serum IL-17A≥33.96pg/ml, OXA≤249.70pg/ml were the influencing factors of POCD. Conclusion: Serum IL-17A and OXA levels are the influencing factors of cognitive dysfunction in elderly patients of hip fracture after general anesthesia. They are closely related to cognitive dysfunction and could be used as biomarkers for predicting POCD.
陈梅珠, 罗琳, 田毅. 血清IL-17A OXA对老年髋部骨折全麻术术后认知功能障碍的预测价值[J]. 河北医学, 2022, 28(2): 267-271.
CHEN Meizhu, LUO Lin, TIAN Yi. The Predictive Value of Serum IL-17A and OXA for Postoperative Cognitive Dysfunction in Elderly Patients of Hip Fracture Undergoing General Anesthesia. HeBei Med, 2022, 28(2): 267-271.
[1] Zhang XP,Dong QY,Fang J.Impacts of general and spinal anaesthesia on short-term cognitive function and mental status in elderly patients undergoing orthopaedic surgery[J].Coll Physicians Surg Pak,2019,29(2):101~104. [2] Zhang HF,Zheng JW,Wang RC,et al.Serum phosphorylated neurofilament heavy subunit-H,a potential predictive biomarker for postoperative cognitive dysfunction in elderly subjects undergoing hip joint arthroplasty[J].Arthroplasty,2019,34(8):1602~1605. [3] Green HF,Khosousi S,Svenningsson P.Plasma IL-6 and IL-17A Correlate with Severity of Motor and Non-Motor Symptoms in Parkinson's Disease[J].Parkinsons Dis,2019,9(4):705~709. [4] 王以新,梁忆非,唐小云,等.白细胞介素17A与老年腹部手术患者术后认知功能障碍的相关性[J].中华临床医师杂志(电子版),2017,11(5):742~747. [5] Yu XL,Xie YF.Effect of dexmedetomidine combined with etomidate on IL-17A and S-100beta expression levels in rats with postoperative cognitive dysfunction[J].Exp Ther Med,2020,20(6):275. [6] Steward T,Mestre-Bach G,Granero R,et al.Reduced plasma orexin-A concentrations are associated with cognitive deficits in anorexia nervosa[J].Sci Rep,2019,9(1):7910. [7] Zajo KN,Fadel JR,Burk JA.Orexin A-induced enhancement of attentional processing in rats:role of basal forebrain neurons[J].Psychopharmacology,2016;233(4):639~647. [8] 王淑娟,陶利军.老年腰椎手术全麻术后患者早期认知功能与食欲素A的相关性研究[J].解放军医学杂志,2020,45(8):845~850. [9] Tsuneki H,Wada T,Sasaoka T.Chronopathophysiological implications of orexin in sleep disturbances and lifestyle-related disorders[J].Pharmacology & Therapeutics,2018,186 (6):25~44.
2022, Vol. 28 
冀公网安备13080202000677号