2020 Fiscal Year Final Research Report
Investigation of mechanism of pathogenesis of postoperative and sepsis-associated delirium and cognitive dysfunction and development of the prophylaxis.
| Project/Area Number |
17H04319
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Anesthesiology
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| Research Institution | Hirosaki University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
上野 伸哉 弘前大学, 医学研究科, 教授 (00312158)
櫛方 哲也 弘前大学, 医学研究科, 准教授 (80250603)
二階堂 義和 弘前大学, 医学研究科, 講師 (50613478)
橋場 英二 弘前大学, 医学部附属病院, 准教授 (10374844)
村上 学 弘前大学, 医学研究科, 教授 (80302090)
斎藤 淳一 弘前大学, 医学部附属病院, 助教 (90647413)
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| Project Period (FY) |
2017-04-01 – 2021-03-31
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| Keywords | 譫妄 / 認知機能 / 手術侵襲 / 敗血症 / 高齢者 |
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| Outline of Final Research Achievements |
Animal study: Lipopolysaccharide (LPS)-treated aged rats displayed a decreased object discrimination index, elevation of lipocalin-2 (LCN2) levels and ferrous ion levels in the hippocampus and the cortex. Pretreatment with the iron chelator deferoxamine (DFO) prevented the reduction in the object discrimination index of LPS-treated aged rats. The elevation in hippocampal and cortical LCN2 levels caused by LPS was not influenced by DFO pretreatment. The LPS-induced ferrous ion level elevation was blocked by DFO pretreatment.
Clinical Study: Plasma inflammatory markers significantly increased during radical cancer surgery in patients with esophageal or oral floor cancer. However, there was significant differences in plasma inflammatory biomarkers between patients with or without postoperative delirium (POD). Both density and ratio of α wave power were significantly higher in non-POD patients than POD patients.
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| Free Research Field |
麻酔科学
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| Academic Significance and Societal Importance of the Research Achievements |
基礎研究では、高齢敗血症ラットでの認知機能低下に鉄代謝が関与していることが分かり、鉄キレート剤で改善したことから、新たな創薬に結び付く可能性がある。臨床研究では、脳波のα波に麻酔導入直後から、術後譫妄が生じた患者では生じなかった患者より有意にα波パワー密度、相対的α波が低く、脳波により術後譫妄を予測でき、早めに介入することで譫妄を抑制できる可能性がある。また、譫妄患者も非譫妄患者も、全身炎症の程度は同様であり、炎症だけでは譫妄は生じないことが分かった。
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