| Citation: |
DAI Min, YANG Zichang, HU Ruilin, LI Qianqian, YI Jianmin, YU Qi. Values of brain fatty-type acid binding protein and kallikrein-6 in peripheral blood in predicting postoperative cognitive dysfunction of senile patients with hip replacement[J]. Journal of Clinical Medicine in Practice, 2023, 27(12): 44-49. DOI: 10.7619/jcmp.20230999
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To explore the values of brain fatty-type acid binding protein (B-FABP) and kallikrein-6 (KLK6) in peripheral blood in predicting postoperative cognitive dysfunction (POCD) of senile patients with hip replacement.
A total of 145 senile patients with hip replacement were selected, and they were divided into POCD group (n=39) and non-POCD group (n=106) according to result of the Montreal Cognitive Assessment (MoCA) at 7 days after surgery. The levels of serum B-FABP and KLK6 before surgery as well as 3 and 7 days after surgery were compared between two groups; the Pearson method was used to analyze the correlation between serum indicators and the MoCA scores at different time points; the single factor and multivariate Logistic regression analysis were used to determine the influencing factors for occurrence of POCD; the receiver operatingcharacteristic (ROC) curve was used to analyze the diagnostic efficiency of serum indicators for POCD.
At 3 and 7 days after surgery, the B-FABP levels in the POCD group were significantly higher than that in the non-POCD group, while the KLK6 levels were significantly lower than that in the non-POCD group (P < 0.05). Pearson correlation analysis showed that cognitive impairment score was negatively correlated with the B-FABP at 3 and 7 days after surgery (r=-0.469, -0.341, P < 0.05), while was positively correlated with the KLK6 at 3 and 7 days after surgery (r=0.891, 0.473, P < 0.05). The results of Logistic regression analysis showed that B-FABP at 3 days after surgery (OR=1.898, 95%CI, 1.202 to 2.997), B-FABP at 7 days after surgery (OR=1.669, 95%CI, 1.125 to 2.474), KLK6 at 3 days after surgery (OR=0.676, 95%CI, 0.553 to 0.828), and KLK6 at 7 days after surgery (OR=0.604, 95%CI, 0.400 to 0.912) were the influencing factors for the occurrence of POCD. The ROC curve showed that when the critical value of B-FABP at 3 days after surgery was 156.34 ng/L, the corresponding sensitivity was 69.23%, the specificity was 70.75%, and the area under the curve (AUC) was 0.801 (95%CI, 0.750 to 0.852); when the critical value of B-FABP at 7 days after surgery was 133.02 ng/L, the corresponding sensitivity was 71.79%, specificity was 71.70%, and AUC was 0.760 (95%CI, 0.707 to 0.812); when the critical value of KLK6 at 3 days after surgery was 5.52 μg/L, the corresponding sensitivity was 58.97%, specificity was 60.38%, and AUC was 0.631 (95%CI, 0.564 to 0.698); when the critical value of KLK6 at 7 days after surgery was 6.01 μg/L, the corresponding sensitivity was 61.54%, specificity was 63.21%, and AUC was 0.708 (95%CI, 0.645 to 0.772); based on the Logistic regression results, a risk prediction model for the combined application of the above four indicators was established, and when the critical value of the model was 1.29 (excluding the constant term), the corresponding sensitivity was 82.05%, specificity was 80.19%, and AUC was 0.869 (95%CI, 0.831 to 0.907).
Serum B-FABP and KLK6 are closely related to the occurrence of POCD in patients with hip replacement, single and combined detection can effectively predict the occurrence of POCD, and clinical intervention should be performed according to the indicators.
| [1] |
BIALYSTOK E. Bilingualism: pathway to cognitive reserve[J]. Trends Cogn Sci, 2021, 25(5): 355-364. doi: 10.1016/j.tics.2021.02.003
|
| [2] |
GRANGER K T, BARNETT J H. Postoperative cognitive dysfunction: an acute approach for the development of novel treatments for neuroinflammation[J]. Drug Discov Today, 2021, 26(5): 1111-1114. doi: 10.1016/j.drudis.2021.01.019
|
| [3] |
WANG Y L, ZHANG Y, CAI D S. Dexmedetomidine ameliorates postoperative cognitive dysfunction via the microRNA-381-mediated EGR1/p53 axis[J]. Mol Neurobiol, 2021, 58(10): 5052-5066. doi: 10.1007/s12035-021-02417-7
|
| [4] |
李智, 李虎, 姚尚龙, 等. 右美托咪定剂量对老年脊柱手术患者术后认知功能障碍发生率及Aβ和细胞因子水平的影响: 120例随机对照试验[J]. 南方医科大学学报, 2021, 41(4): 600-606. https://www.cnki.com.cn/Article/CJFDTOTAL-DYJD202104019.htm
|
| [5] |
GUO Q Y, KAWAHATA I, DEGAWA T, et al. Fatty acid-binding proteins aggravate cerebral ischemia-reperfusion injury in mice[J]. Biomedicines, 2021, 9(5): 529. doi: 10.3390/biomedicines9050529
|
| [6] |
YOON H, TRIPLET E M, SIMON W L, et al. Blocking Kallikrein 6 promotes developmental myelination[J]. Glia, 2022, 70(3): 430-450. doi: 10.1002/glia.24100
|
| [7] |
CARLEW A R, SMITH E E, GOETTE W, et al. Montreal Cognitive Assessment (MoCA) scores in medically compromised patients: a scoping review[J]. Health Psychol, 2021, 40(10): 717-726. doi: 10.1037/hea0001138
|
| [8] |
蔡鄂, 张天伟, 张震祥, 等. 人工全髋关节置换术手术入路[J]. 骨科临床与研究杂志, 2021, 6(5): 307-312. https://www.cnki.com.cn/Article/CJFDTOTAL-GKLC202105011.htm
|
| [9] |
ZIMMERER A, RAMOSER A, STREIT M, et al. Osteoarthrosis, advanced age, and female sex are risk factors for inferior outcomes after hip arthroscopy and labral debridement for femoroacetabular impingement syndrome: case series with minimum 10-year follow-up[J]. Arthroscopy, 2021, 37(6): 1822-1828, e1. doi: 10.1016/j.arthro.2021.01.024
|
| [10] |
王渭君, 孙明辉, 袁涛, 等. 对转换全髋置换术后感染预防策略的中期临床效果的观察[J]. 骨科临床与研究杂志, 2023, 8(3): 164-169. https://www.cnki.com.cn/Article/CJFDTOTAL-GKLC202303005.htm
|
| [11] |
GE X, ZUO Y, XIE J H, et al. A new mechanism of POCD caused by sevoflurane in mice: cognitive impairment induced by cross-dysfunction of iron and glucose metabolism[J]. Aging, 2021, 13(18): 22375-22389. doi: 10.18632/aging.203544
|
| [12] |
AYTAÇ I, AYTAÇ B G, DEMIRELLI G, et al. Comparison of postoperative cognitive decline using the mini-mental state examination and Montreal cognitive assessment after minor elective surgery in elderly[J]. Cureus, 2021, 13(10): e18631.
|
| [13] |
JIN R, HAO J Q, YI Y M, et al. Regulation of macrophage functions by FABP-mediated inflammatory and metabolic pathways[J]. Biochim Biophys Acta Mol Cell Biol Lipids, 2021, 1866(8): 158964.
|
| [14] |
XU X, WANG Y X, CHOI W S, et al. Super resolution microscopy reveals DHA-dependent alterations in glioblastoma membrane remodelling and cell migration[J]. Nanoscale, 2021, 13(21): 9706-9722. doi: 10.1039/D1NR02128A
|
| [15] |
张蔚, 王文祥, 赵伟红, 等. 老年脊柱手术患者血清中H-FABP、B-FABP含量变化与术后认知功能改变的相关性[J]. 临床麻醉学杂志, 2019, 35(4): 380-383. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201904020.htm
|
| [16] |
PANDEY R, ZHOU M H, CHEN Y L, et al. Molecular pathways associated with kallikrein 6 overexpression in colorectal cancer[J]. Genes, 2021, 12(5): 749. doi: 10.3390/genes12050749
|
| [17] |
YUAN L, ZOU D D, YANG X, et al. Proteomics and functional study reveal kallikrein-6 enhances communicating hydrocephalus[J]. Clin Proteomics, 2021, 18(1): 30. doi: 10.1186/s12014-021-09335-9
|
| [18] |
O′GORMAN P, LAUBACH J P, O′DWYER M E, et al. Phase 2 studies of lenalidomide, subcutaneous bortezomib, and dexamethasone as induction therapy in patients with newly diagnosed multiple myeloma[J]. Am J Hematol, 2022, 97(5): 562-573. doi: 10.1002/ajh.26491
|
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