饮茶习惯与老年患者术后谵妄的关系

Relationship between tea drinking habit and postoperative delirium in elderly patients

目的评价饮茶习惯与老年患者术后谵妄(POD)的关系。方法选择在脊椎-硬膜外阻滞下行膝/髋关节置换术老年患者292例,年龄65~85岁,体重50~80 kg,ASA分级Ⅰ~Ⅲ级。术前1 d完成简易精神状态评定量表(MMSE),评估术前认知状态。麻醉前抽取外周静脉血,采用ELISA法检测血浆咖啡因和茶多酚的浓度。术后于麻醉复苏室、1、3、7 d(或出院前)同一时段进行神经心理学测试,采用谵妄评定量表判断POD的发生。根据术后是否发生POD分为POD组(P组)和非POD组(NP组),将差异有统计学意义的变量进行logistic回归分析。结果与NP组比较,P组年龄、ASA分级、血浆咖啡因浓度和茶多酚浓度差异有统计学意义(P<0.05)。logistic回归分析结果显示,年龄是POD的独立危险因素,血浆咖啡因浓度、茶多酚浓度和饮茶习惯是减少老年患者POD发生的保护性因素。结论饮茶习惯是减少老年患者POD发生的保护性因素。

Objective To evaluate the relationship between the tea drinking habit and postoperative delirium(POD)in elderly patients.Methods Two hundred and ninety-two patients,aged 65-85 yr,weighing 50-80 kg,of American Society of Anesthesiologists physical statusⅠ-Ⅲ,undergoing elective knee/hip arthroplasty under spinal-epidural anesthesia in our hospital,were enrolled in this study.The patient′s cognitive function was assessed using Mini-Mental State Examination at 1 day before operation.Peripheral venous blood samples were collected before anesthesia,and the concentrations of caffeine and tea polyphenols in plasma were measured by enzyme-linked immunosorbent assay.In the anesthesia recovery room after operation and at 1,3 and 7 days after operation(or before discharge),neuropsychological tests were performed,and the Delirium Rating Scale was used to recognize POD developed.The patients were divided into POD group(P group)and non-POD group(NP group)according to whether POD occurred after operation.Logistic regression analysis was used to analyze the variables of which P values were less than 0.05.Results There was no significant difference in age,American Society of Anesthesiologists physical status,concentrations of caffeine and tea polyphenols in plasma between P group and NP group(P<0.05).The results of logistic regression analysis showed that age was an independent risk factor for POD,and concentrations of caffeine and tea polyphenols in plasma and tea drinking habits were protective factors for reducing the occurrence of POD in elderly patients.Conclusion Tea drinking habit is a protective factor for reducing the occurrence of POD in elderly patients.