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| 术前脑状态指数预测老年患者神经认知功能的有效性 |
| Efficacy of preoperative cerebral state index predicting neurocognitive function in elderly patients |
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| DOI：10.12089/jca.2019.12.012 |
| 中文关键词: 脑状态指数 认知功能 老年患者 ROC曲线 |
| 英文关键词: Cerebral state index Cognitive function Elderly ROC curve |
| 基金项目:上海交通大学附属胸科医院重大重点项目(2014YCDCT0500) |
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| 中文摘要: |
目的 观察老年患者术前认知功能损伤的发生率,并探讨脑状态指数(cerebral state index, CSI)评估老年患者术前认知功能损伤的有效性。
方法 择期肺切除手术的老年患者105例,男54例,女51例,年龄65～80岁,BMI 18～30 kg/m2,ASA Ⅰ-Ⅲ级。术前行CSI监测和中国改良版蒙特利尔认知功能测试(MoCA)。根据MoCA测试结果将患者分为术前认知功能正常组(MoCA≥26分,N组)和认知功能异常组(MoCA<26分,AN组)。以MoCA认知功能测试结果为金标准,基于患者术前CSI建立回归方程,计算认知指数;采用ROC曲线检验认知指数预测术前认知功能损伤的效能。
结果 有50例(47.6％)患者存在术前认知功能损伤。基于认知指数构建的预测模型诊断老年患者术前认知功能损伤的阈值为0.5,敏感性66.7％,特异性69.2％,曲线下面积(AUC)为0.699(95％CI 0.563～0.835,P=0.007)。
结论 老年患者术前认知功能损伤的发生率较高,术前脑状态指数能够预测其认知功能损伤,但效能一般。 |
| 英文摘要: |
Ojective To observe the incidence of preoperative cognitive impairment of elderly patients and explore whether the cerebral state index (CSI) based on EEG could be used for cognitive function assessment.
Methods A total of 105 patients undergoing elective thoracic surgery, 54 males and 51 females, aged 65-80 years, BMI 18-30 kg/m2, ASA physical status Ⅰ-Ⅲ, were involved in the study. Brain function assessment and Chinese modified version of Montreal cognitive assessment testing (MoCA) were performed before surgery. According to MoCA, the patients were divided into normal group (MoCA≥26 scores, group N) and abnormal group (MoCA < 26 scores, group AN). Regarding the results of MoCA testing as the gold standard, logistic regression equations were established based on CSI (brain chaos, internal concentration, brain introversion, memory processing, reaction speed) in patients. the cognitive index was calculated. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate CSI to differentiate the cut-off points and efficacy of CI for predicting the cognitive impairment.
Results The incidence of cognitive impairment in elderly patients before thoracic surgery was 47.6％. A model based on cognitive index could diagnose preoperative cognitive impairment in elderly patients (AUC=0.699, P=0.007, when threshold was 0.5, sensitivity was 66.7％, specificity was 69.2％).
Conclusion The incidence of cognitive impairment in elderly patients before thoracic surgery is higher. Preoperative cerebral state index based on EEG extraction could predict cognitive function impairment, but the power of test is moderate. |
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