摘要
[目的]利用受试者工作特征(receiver operating characteristic,ROC)曲线评价外周血白细胞介素-6(interleukin-6,IL-6)对老年半髋关节置换术患者术后谵妄(postoperative delirium,POD)的预测价值。[方法]选取2019年1月—2021年6月在本院进行半髋关节置换术的老年患者。采用意识模糊评分法(confusion assessment method,CAM)评估术后1周内谵妄的发生情况。检测患者术前,术后第1、3、5和7 d的外周静脉血IL-6含量。采用ROC曲线评价IL-6对术后谵妄发生的预测价值。[结果]本研究共纳入210例患者,30例发生了POD,发生率为14.29%。术前两组患者外周血IL-6含量的差异无统计学意义(P>0.05);术后第1 d和第3 d POD组外周血IL-6含量均显著高于非POD组(P<0.05);而术后第5和7 d时两组外周血IL-6含量的差异均无统计学意义(P>0.05)。ROC曲线分析提示:术后第1 d和3 d时外周血IL-6含量预测术后谵妄的曲线下面积(area under curve,AUC)分别为0.81和0.88,具有预测价值。[结论]老年股骨颈骨折进行半髋关节置换术患者术后谵妄发生率为14.29%,术后前3 d监测患者外周血IL-6含量对术后谵妄发生有较高的预测价值。
[Objective]To evaluate the role of peripheral blood interleukin-6(IL-6)predicting postoperative delirium(POD)after hip hemiarthroplasty by receiver operating characteristic(ROC)curve in elderly.[Methods]The aged patients who underwent hip hemiarthroplasty in our hospital from January 2019 to June 2021 were included into this study.Confusion assessment method(CAM)was used to evaluate whether or not POD happened within 1 week after operation.The levels of IL-6 in peripheral venous blood were measured before surgery and at 1,3,5 and 7 days postoperatively.ROC curve analysis was conducted to evaluate the predictive value of IL-6 for POD.[Results]Of the 210 patients enrolled in this study,30 patients developed POD,with an incidence of 14.29%.There was no significant difference in peripheral blood IL-6 content between the groups before operation(P>0.05).However,the POD group had significantly higher blood IL-6 levels than the non-POD group at 1 and 3 days postoperatively(P<0.05),which became not statistically significant between the two groups at 5 and 7 days after surgery(P>0.05).ROC curve analysis indicated that the area under curve(AUC)of IL-6 in peripheral blood at 1 d and 3 d after surgery for predicting postoperative delirium was 0.81 and 0.88,respectively,which had predictive value.[Conclusion]The incidence of postoperative delirium in elderly patients with hip hemiarthroplasty for femoral neck fracture is 14.29%.Monitoring the level of IL-6 in peripheral blood in the first 3 days after surgery has high predictive value for postoperative delirium.
作者
梁峰
杜云峰
王红星
杨小超
吴卫宾
刘国印
陈建民
LIANG Feng;DU Yun-feng;WANG Hong-xing;YANG Xiao-chao;WU Wei-bin;LIU Guo-yin;CHEN Jian-min(Department of Orthopedics,Central Hospital,Jiaozuo Coal Industry(Group)Co.,Ltd.,Jiaozuo 454000,China;Department of Orthopedics,Qinhuai Medical Area,General Hospital of Eastern Theater Command of PLA,Nanjing,210002,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2022年第21期1925-1929,共5页
Orthopedic Journal of China
基金
国家自然科学基金青年科学基金项目(编号:82102547)
江苏省自然科学基金面上项目(编号:BK20181113)。
