术前血清NETs水平与老年腹腔镜切除结直肠肿瘤患者术后谵妄发生的关系及其预测价值

Relationship between preoperative serum levels of NETs and postoperative delirium in elderly patients undergoing laparoscopic resection of colorectal tumors and its predictive value

目的:探讨术前血清中性粒细胞胞外诱捕网(NETs)水平与老年腹腔镜切除结直肠肿瘤患者术后谵妄(POD)发生的关系及其预测价值。方法:选取2023年1—10月我院69例接受腹腔镜结直肠肿瘤切除手术的老年患者,根据术后7 d内是否发生谵妄将其分为谵妄组(n=12)和非谵妄组(n=57),比较两组基线资料及术前血清NETs水平,分析老年腹腔镜切除结直肠肿瘤患者发生POD的影响因素,以及术前血清NETs水平对POD的预测价值。结果:多因素logistic回归分析显示,术前血清NETs生物标志物中的人髓过氧化物酶(MPO)-DNA及人中性粒细胞弹性蛋白酶(NE)水平升高是老年腹腔镜切除结直肠肿瘤患者发生POD的独立危险因素(P<0.05)。ROC曲线分析显示,MPO-DNA及NE预测POD的曲线下面积分别为0.9240、0.8582,敏感度分别为83.3%、75.0%,特异度分别为91.2%、96.5%。结论:术前血清NETs水平升高与老年腹腔镜切除结直肠肿瘤患者发生POD有关,且具有较高的预测价值。

Objective:To explore the relationship between preoperative serum levels of neutrophil extracellular traps(NETs)and postoperative delirium(POD)in elderly patients undergoing laparoscopic resection of colorectal tumors and its predictive value.Methods:69 elderly patients who underwent laparoscopic resection of colorectal tumors in our hospital were selected from January to October 2023.They were divided into a delirium group(n=12)and a non-delirium group(n=57)based on whether they experienced delirium within 7 days after surgery.Baseline data and preoperative serum NETs levels were compared between the two groups.The influencing factors of POD in elderly patients undergoing laparoscopic resection of colorectal tumors were analyzed as well as the predictive value of preoperative serum NETs levels for POD.Results:Multivariate logistic regression analysis showed that elevated levels of preoperative serum NETs biomarkers including human myeloperoxidase(MPO)DNA and neutrophil elastase(NE)were independent risk factors for POD in elderly patients undergoing laparoscopic resection of colorectal tumors(P<0.05).ROC curve analysis showed that the areas under the curve of MPO-DNA and NE for predicting POD were 0.9240 and 0.8582,respectively;the sensitivities were 83.3% and 75.0%,respectively;the specificities were 91.2% and 96.5%,respectively.Conclusion:Elevated preoperative serum NETs levels are associated with the occurrence of POD in elderly patients undergoing laparoscopic resection of colorectal tumors.It has high value in predicting POD.