术前脑脊液相关蛋白表达差异预测老龄患者围术期神经认知功能障碍的临床研究

Objective To investigate the predictive value of preoperative cerebrospinal fluid(CSF) levels of high mobility group box 1(HMGB1), prostaglandin D2 synthase(PTGDS), and tissue inhibitor of metalloproteinases 1(TIMP1) for perioperative neurocognitive dysfunction(PND) in elderly patients. Methods A total of 120 elderly patients(≥65 years) who underwent transurethral resection of the prostate(TURP) from January 2023 to December 2024 at our hospital were selected. Preoperative CSF samples were collected to measure the concentrations of HMGB1, PTGDS, and TIMP1. Patients' cognitive functions were assessed preoperatively and at one week and one month postoperatively using the Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA). Based on the postoperative cognitive changes, patients were divided into PND and non-PND groups, and the differences in preoperative protein expression levels and their correlation with PND were analyzed. Results The levels of HMGB1, TIMP1, and PTGDS in the preoperative CSF of the PND group were significantly higher than those of the non-PND group(P<0.05). Western blotting analysis showed that the expression levels of HMGB1, PTGDS, and TIMP1 proteins in the CSF of the PND group were markedly increased compared to the non-PND group(P<0.05). Receiver operating characteristic curve analysis indicated that the combined detection of HMGB1, PTGDS, and TIMP1 for predicting PND yielded an area under the curve of 0.923, with a specificity of 88.3%. Conclusion Preoperative CSF levels of HMGB1, PTGDS, and TIMP1 are closely associated with the occurrence of PND in elderly patients. The combined detection of these proteins provides a valuable predictive tool for P.