从谵妄的血清生物标志物探讨谵妄发生机制.PDFVIP

生物医学工程学杂志 2017年6月第34卷第3期 • 1 •   ·综 述· 从谵妄的血清生物标志物探讨谵妄发生机制 1, 2 1 1, 2 王艳艳 ，廖玉麟，岳冀蓉 1. 四川大学华西医院 国家老年疾病临床医学研究中心（成都   610041 ） 2. 四川大学华西医院 老年医学中心（成都   610041 ） 【摘要】   谵妄是由多种影响因素引起大脑皮质功能障碍而发生的急性认知功能紊乱。目前关于谵妄病理生 理机制的基础研究较少。谵妄生物标志物的研究有助于阐明其病理生理机制，且对其诊断、严重程度分级及远期 结局预测有着重要意义。本文回顾了谵妄相关的三类血清生物标志物的研究进展：① 风险标志物：谵妄发作前 在血清中出现或增高表达，包括血清化学物、基因标志物等。② 活性标志物：谵妄发生时增高表达，恢复时表达 水平降低，包括乙酰胆碱、血清抗胆碱能活性、5-羟色胺、血清氨基酸、褪黑素、白细胞介素和 C-反应蛋白等炎症 标志物。③ 终产物：根据疾病的严重程度或结局呈比例升高，包括 S-100ß 、神经元特异性烯醇酶等。以上三类 标志物有助于我们进一步探讨谵妄的发生机制。 【关键词】  谵妄；血清生物标志物；谵妄机制 Research on the mechanism of delirium based on related serum bio-markers of the delirium 1, 2 1 1, 2 WANG Yanyan , LIAO Yulin , YUE Jirong 1. National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, P.R.China 2. Medical Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, P.R.China Corresponding author: YUE Jirong, Email: yuejirong11@ 【Abstract 】 Delirium is an acute cognitive disorder caused by a variety of factors which lead to cerebral cortical dysfunction. At present the studies on the pathophysiology of delirium is still very few. But studies on serum biomarker of delirium can help to elucidate the pathophysiological mechanism of delirium, and the studies are significant for delirium diagnosis, (severity classification and prediction of long-term outcome. This review examines three major groups of delirium related serum biomarkers: (1) risk markers: those that are present or elevated prior to disease onset, including serum chemistries, genetic markers and insulin-like growth factor-1; (2) disease markers: those markers elevate with d