Cerebrospinal Fluid Phosphate in Delirium after Hip Fracture.
Cerebrospinal Fluid Phosphate in Delirium after Hip Fracture.
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DOI：
10.1159/000478723
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发表时间：
2017-09
影响因子：
2.3
通讯作者：
Watne LO
中科院分区：
文献类型：
--
作者：
Idland AV;Wyller TB;Støen R;Dahl GT;Frihagen F;Brækhus A;Hassel B;Watne LO
磷酸盐对神经元的活动是必不可少的。我们的目的是调查精神错乱是否与脑脊液(CSF)和血清中磷浓度的改变有关。对77例髋部骨折患者进行了急性手术前后的精神障碍评估。一个专家小组对预裂裂性痴呆进行了诊断。测定腰麻前即刻脑脊液(n=77)和血清(n=47)的磷酸盐。对23例认知健康的老年腰麻患者的脑脊液进行了分析。髋部骨折合并精神障碍患者的脑脊液磷酸盐浓度明显高于无精神障碍患者(中位数0.63vs.0.55mmol.L，p=0.001)。在按痴呆症状态分层的分析中，这种差异只在痴呆症患者中显著。血磷为∼1 mmo1/L，血磷浓度与神志不清状态无关。脑脊液磷酸盐与血清水平无相关性。痴呆症叠加精神错乱的患者磷酸盐水平升高。
Phosphate is essential for neuronal activity. We aimed to investigate whether delirium is associated with altered phosphate concentrations in cerebrospinal fluid (CSF) and serum. Seventy-seven patients with hip fracture were assessed for delirium before and after acute surgery. Prefracture dementia was diagnosed by an expert panel. Phosphate was measured in CSF obtained immediately before spinal anesthesia (n = 77) and in serum (n = 47). CSF from 23 cognitively healthy elderly patients undergoing spinal anesthesia was also analyzed. Hip fracture patients with prevalent delirium had higher CSF phosphate concentrations than those without delirium (median 0.63 vs. 0.55 mmol/L, p = 0.001). In analyses stratified on dementia status, this difference was only significant in patients with dementia. Serum phosphate was ∼1 mmol/L; there was no association between serum phosphate concentration and delirium status. CSF phosphate did not correlate with serum levels. Patients with delirium superimposed on dementia have elevated phosphate levels.