CAJ | 학술논문

目的探讨载脂蛋白E(ApoE)基因多态性与老年非心脏手术患者术后谵妄是否具有相关性.方法 212例65岁以上的择期非心脏手术患者纳入研究,于手术后1～3 d密切随访,根据CAM的标准判断患者有无发生谵妄.用突变特异性多重扩增系统(multi-ARMS PCR)方法测定患者ApoE基因型.结果 212例患者中有45例发生术后谵妄,共检出ApoE ε4等位基因携带者18例(8.5%).谵妄组有3例ApoE ε4携带者(6.7%),非谵妄组有15例ApoEε4携带者(9.0%),两组比较无显著差异.ε4/4纯合子型共有4例,其中1例术前3 d发生过一过性谵妄,还有1例发生术后严重谵妄,症状持续17 d.结论 ApoE ε4等位基因与术后谵妄发病率无显著的相关性,但ε4/4纯合子型可能更容易发生谵妄.
목적 탐토재지단백E(ApoE)기인다태성여노년비심장수술환자술후섬망시부구유상관성.방법 212례65세이상적택기비심장수술환자납입연구,우수술후1～3 d밀절수방,근거CAM적표준판단환자유무발생섬망.용돌변특이성다중확증계통(multi-ARMS PCR)방법측정환자ApoE기인형.결과 212례환자중유45례발생술후섬망,공검출ApoE ε4등위기인휴대자18례(8.5%).섬망조유3례ApoE ε4휴대자(6.7%),비섬망조유15례ApoEε4휴대자(9.0%),량조비교무현저차이.ε4/4순합자형공유4례,기중1례술전3 d발생과일과성섬망,환유1례발생술후엄중섬망,증상지속17 d.결론 ApoE ε4등위기인여술후섬망발병솔무현저적상관성,단ε4/4순합자형가능경용역발생섬망.
Objective To investigate whether apolipoprotein E (ApoE) genotypes is associated with postoperative delirium in aged noncardiac surgical patients. Methods Two hundreds and twelve inpatients over 65y, undergoing selective noncardiac surgeries were enrolled in the study. The patients were frequently interviewed and evaluated prospectively for delirium with the Confusion Assessment Method (CAM) during the first three postoperative days. APOE genotype was determined using multiplex amplification refractory mutation system pelymerase chain reaction (multi-ARMS PCR) technique. Results Delirium occurred in 45 patients during the first three postoperative days. Of the 212 patients, 18 (8.5%) possessed one or two ApoE 84 allele. There was no significant difference between delirious patients and non-delirious patients(6.7% : 9.0%, P >0.05) in the presence of ApoE ε4 allele. In all four ApoE ε4/4 homozygote patients, one female patient presented a transient delirium status three days be-fore surgery, another male patient presented serious fluctuated delirium symptoms from the second to 17th days after operation. Conclusion The presence of ApoE ε4 allele seems not a predictator of postoperative delirium. ApoE ε4/4 homozygote patients may be more indulgent to delirium than others.