研究动态
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重症监护病房康复者神经精神功能障碍的生物标志物:前瞻性队列研究。

Biomarkers of neuropsychiatric dysfunction in intensive care unit survivors: a prospective cohort study.

发表日期:2023
作者: Franciani Rodrigues da Rocha, Renata Casagrande Gonçalves, Gabriele da Silveira Prestes, Danusa Damásio, Amanda Indalécio Goulart, Andriele Aparecida da Silva Vieira, Monique Michels, Maria Inês da Rosa, Cristiane Ritter, Felipe Dal-Pizzol
来源: BIOMEDICINE & PHARMACOTHERAPY

摘要:

为评估与长期神经精神状况相关的因素,包括深度监护病房出院后测量的生物标志物。进行了一项前瞻性队列研究,共有65名深度监护病房幸存者。通过Mini-Mental State Examination完成了认知评估,使用Hospital Anxiety and Depression Scale评估焦虑和抑郁症状,使用Impact of Event Scale-6评估创伤后应激障碍。在深度监护病房出院时测量了淀粉样β (1-42) [Aβ (1-42)],Aβ (1-40),白细胞介素-10 (IL-10),白细胞介素-6 (IL-6),白细胞介素-33 (IL-33),白细胞介素-4 (IL-4),白细胞介素-5 (IL-5),肿瘤坏死因子α,C-反应蛋白,以及脑源性神经营养因子的血浆水平。 在与深度监护病房相关的变量中,只有谵妄与长期认知损伤的发生独立相关。此外,较高水平的IL-10和IL-6与认知功能障碍相关。只有IL-6独立与抑郁症相关。机械通气、IL-33水平和C-反应蛋白水平与焦虑相关。没有变量与创伤后应激障碍独立相关。 对于幸存重症患者来说,认知功能障碍、抑郁、焦虑和创伤后应激障碍的症状存在,并且其中一些结果与深度监护病房出院时测量的炎症生物标志物水平相关。
To assess factors associated with long-term neuropsychiatric outcomes, including biomarkers measured after discharge from the intensive care unit.A prospective cohort study was performed with 65 intensive care unit survivors. The cognitive evaluation was performed through the Mini-Mental State Examination, the symptoms of anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale, and posttraumatic stress disorder was evaluated using the Impact of Event Scale-6. Plasma levels of amyloid-beta (1-42) [Aβ (1-42)], Aβ (1-40), interleukin (IL)-10, IL-6, IL-33, IL-4, IL-5, tumor necrosis factor alpha, C-reactive protein, and brain-derived neurotrophic factor were measured at intensive care unit discharge.Of the variables associated with intensive care, only delirium was independently related to the occurrence of long-term cognitive impairment. In addition, higher levels of IL-10 and IL-6 were associated with cognitive dysfunction. Only IL-6 was independently associated with depression. Mechanical ventilation, IL-33 levels, and C-reactive protein levels were independently associated with anxiety. No variables were independently associated with posttraumatic stress disorder.Cognitive dysfunction, as well as symptoms of depression, anxiety, and posttraumatic stress disorder, are present in patients who survive a critical illness, and some of these outcomes are associated with the levels of inflammatory biomarkers measured at discharge from the intensive care unit.