{"title":"静脉全麻对心脏经导管封堵术患者昼夜节律的影响","authors":"Yun-Fei Gu, Zhen-Xing Bao, Kai-Hua Yu, Ling Wang, Dian-Wei Cheng, Su-Heng Chen, Yu-Lan Li","doi":"10.3881/j.issn.1000-503X.15896","DOIUrl":null,"url":null,"abstract":"<p><p>Objective To evaluate the effects of total intravenous anesthesia on the circadian rhythms in the patients undergoing cardiac transcatheter closure. Methods Thirty patients undergoing cardiac transcatheter closure under elective intravenous anesthesia were included in this study.Paired <i>t</i>-tests were performed to compare the mRNA levels of the genes encoding circadian locomotor output cycles kaput(CLOCK),brain and muscle ARNT-1 like protein-1(BMAL1),cryptochrome 1(CRY1),and period circadian clock 2(PER2),the Munich Chronotype Questionnaire(MCTQ)score,and the Pittsburgh Sleep Quality Index(PSQI)score before and after anesthesia.Multiple stepwise regression analysis was performed to screen the factors influencing sleep chronotype and PSQI total score one week after surgery. Results The postoperative mRNA level of CLOCK was higher [1.38±1.23 <i>vs</i>.1.90±1.47;<i>MD</i>(95%<i>CI</i>):0.52(0.20-0.84),<i>t</i>=3.327,<i>P</i>=0.002] and the postoperative mRNA levels of CRY1 [1.56±1.50 <i>vs</i>.1.13±0.98;<i>MD</i>(95%<i>CI</i>):-0.43(-0.81--0.05),<i>t</i>=-2.319,<i>P</i>=0.028] and PER2 [0.82±0.63 <i>vs</i>.0.50±0.31;<i>MD</i>(95%<i>CI</i>):-0.33(-0.53--0.12),<i>t</i>=-3.202,<i>P</i>=0.003] were lower than the preoperative levels.One week after surgery,the patients presented advanced sleep chronotype [3:03±0:59 <i>vs</i>.2:42±0:37;<i>MD</i>(95%<i>CI</i>):-21(-40--1),<i>t</i>=-2.172,<i>P</i>=0.038],shortened sleep latency [(67±64)min <i>vs</i>.(37±21)min;<i>MD</i>(95%<i>CI</i>):-30.33(-55.28--5.39),<i>t</i>=-2.487,<i>P</i>=0.019],lengthened sleep duration [(436±83)min <i>vs</i>.(499±83)min;<i>MD</i>(95%<i>CI</i>):62.80(26.93-98.67),<i>t</i>=3.581,<i>P</i>=0.001],increased sleep efficiency [(87.59±10.35)% <i>vs</i>.(92.98±4.27)%;<i>MD</i>(95%<i>CI</i>):5.39(1.21-9.58),<i>t</i>=2.636,<i>P</i>=0.013],decreased sleep quality score [1.13±0.78 <i>vs</i>.0.80±0.71;<i>MD</i>(95%<i>CI</i>):-0.33(-0.62--0.05),<i>t</i>=-2.408,<i>P</i>=0.023],and declined PSQI total score [6.60±3.17 <i>vs</i>.4.03±2.58;<i>MD</i>(95%<i>CI</i>):-2.57(-3.87--1.27),<i>t</i>=-4.039,<i>P</i><0.001].Body mass index(BMI)(<i>B</i>=-227.460,<i>SE</i>=95.475,<i>t</i>=-2.382,<i>P</i>=0.025),anesthesia duration(<i>B</i>=-47.079,<i>SE</i>=18.506,<i>t</i>=-2.544,<i>P</i>=0.017),and mRNA level of PER2(<i>B</i>=2815.804,<i>SE</i>=1080.183,<i>t</i>=2.607,<i>P</i>=0.015)collectively influenced the sleep chronotype,and the amount of anesthesia medicine(<i>B</i>=0.067,<i>SE</i>=0.028,<i>t</i>=2.385,<i>P</i>=0.024)independently influenced the PSQI one week after surgery. Conclusion Total intravenous anesthesia can improve sleep habits by advancing sleep chronotype.BMI,anesthesia duration,and mRNA level of PER2 collectively influence sleep chronotype one week after surgery.The amount of anesthesia medicine independently influences the PSQI total score one week after surgery.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Effects of Total Intravenous Anesthesia on Circadian Rhythms in Patients Undergoing Cardiac Transcatheter Closure].\",\"authors\":\"Yun-Fei Gu, Zhen-Xing Bao, Kai-Hua Yu, Ling Wang, Dian-Wei Cheng, Su-Heng Chen, Yu-Lan Li\",\"doi\":\"10.3881/j.issn.1000-503X.15896\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Objective To evaluate the effects of total intravenous anesthesia on the circadian rhythms in the patients undergoing cardiac transcatheter closure. Methods Thirty patients undergoing cardiac transcatheter closure under elective intravenous anesthesia were included in this study.Paired <i>t</i>-tests were performed to compare the mRNA levels of the genes encoding circadian locomotor output cycles kaput(CLOCK),brain and muscle ARNT-1 like protein-1(BMAL1),cryptochrome 1(CRY1),and period circadian clock 2(PER2),the Munich Chronotype Questionnaire(MCTQ)score,and the Pittsburgh Sleep Quality Index(PSQI)score before and after anesthesia.Multiple stepwise regression analysis was performed to screen the factors influencing sleep chronotype and PSQI total score one week after surgery. Results The postoperative mRNA level of CLOCK was higher [1.38±1.23 <i>vs</i>.1.90±1.47;<i>MD</i>(95%<i>CI</i>):0.52(0.20-0.84),<i>t</i>=3.327,<i>P</i>=0.002] and the postoperative mRNA levels of CRY1 [1.56±1.50 <i>vs</i>.1.13±0.98;<i>MD</i>(95%<i>CI</i>):-0.43(-0.81--0.05),<i>t</i>=-2.319,<i>P</i>=0.028] and PER2 [0.82±0.63 <i>vs</i>.0.50±0.31;<i>MD</i>(95%<i>CI</i>):-0.33(-0.53--0.12),<i>t</i>=-3.202,<i>P</i>=0.003] were lower than the preoperative levels.One week after surgery,the patients presented advanced sleep chronotype [3:03±0:59 <i>vs</i>.2:42±0:37;<i>MD</i>(95%<i>CI</i>):-21(-40--1),<i>t</i>=-2.172,<i>P</i>=0.038],shortened sleep latency [(67±64)min <i>vs</i>.(37±21)min;<i>MD</i>(95%<i>CI</i>):-30.33(-55.28--5.39),<i>t</i>=-2.487,<i>P</i>=0.019],lengthened sleep duration [(436±83)min <i>vs</i>.(499±83)min;<i>MD</i>(95%<i>CI</i>):62.80(26.93-98.67),<i>t</i>=3.581,<i>P</i>=0.001],increased sleep efficiency [(87.59±10.35)% <i>vs</i>.(92.98±4.27)%;<i>MD</i>(95%<i>CI</i>):5.39(1.21-9.58),<i>t</i>=2.636,<i>P</i>=0.013],decreased sleep quality score [1.13±0.78 <i>vs</i>.0.80±0.71;<i>MD</i>(95%<i>CI</i>):-0.33(-0.62--0.05),<i>t</i>=-2.408,<i>P</i>=0.023],and declined PSQI total score [6.60±3.17 <i>vs</i>.4.03±2.58;<i>MD</i>(95%<i>CI</i>):-2.57(-3.87--1.27),<i>t</i>=-4.039,<i>P</i><0.001].Body mass index(BMI)(<i>B</i>=-227.460,<i>SE</i>=95.475,<i>t</i>=-2.382,<i>P</i>=0.025),anesthesia duration(<i>B</i>=-47.079,<i>SE</i>=18.506,<i>t</i>=-2.544,<i>P</i>=0.017),and mRNA level of PER2(<i>B</i>=2815.804,<i>SE</i>=1080.183,<i>t</i>=2.607,<i>P</i>=0.015)collectively influenced the sleep chronotype,and the amount of anesthesia medicine(<i>B</i>=0.067,<i>SE</i>=0.028,<i>t</i>=2.385,<i>P</i>=0.024)independently influenced the PSQI one week after surgery. Conclusion Total intravenous anesthesia can improve sleep habits by advancing sleep chronotype.BMI,anesthesia duration,and mRNA level of PER2 collectively influence sleep chronotype one week after surgery.The amount of anesthesia medicine independently influences the PSQI total score one week after surgery.</p>\",\"PeriodicalId\":6919,\"journal\":{\"name\":\"中国医学科学院学报\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中国医学科学院学报\",\"FirstCategoryId\":\"1087\",\"ListUrlMain\":\"https://doi.org/10.3881/j.issn.1000-503X.15896\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中国医学科学院学报","FirstCategoryId":"1087","ListUrlMain":"https://doi.org/10.3881/j.issn.1000-503X.15896","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的 评估全静脉麻醉对心脏经导管封堵术患者昼夜节律的影响。方法 本研究纳入了 30 名在选择性静脉麻醉下接受心脏经导管封堵术的患者。比较麻醉前后编码昼夜节律运动输出周期 kaput（CLOCK）、脑和肌肉 ARNT-1 like protein-1（BMAL1）、隐色素 1（CRY1）和周期昼夜节律时钟 2（PER2）基因的 mRNA 水平、慕尼黑时间型问卷（MCTQ）评分和匹兹堡睡眠质量指数（PSQI）评分，并进行配对 t 检验。对影响术后一周睡眠时型和PSQI总分的因素进行了多元逐步回归分析。结果 CLOCK术后mRNA水平较高[1.38±1.23 vs. 1.90±1.47;MD(95%CI):0.52(0.20-0.84),t=3.327,P=0.002]，CRY1术后mRNA水平较高[1.56±1.50 vs. 1..13±0.98;MD(95%CI):-0.43(-0.81--0.05),t=-2.319,P=0.028] 和 PER2 [0.82±0.63 vs.0术后一周，患者出现晚期睡眠时型[3∶03±0∶59 vs.2(499±83)min;MD(95%CI):62.80(26.93-98.67),t=3.581,P=0.001], 提高睡眠效率[(87.59±10.35)% vs.(92.98±4.27)%;MD(95%CI):5.39(1.21-9.58),t=2.636,P=0.013], 降低睡眠质量评分[1.13±0.78 vs.0..80±0.71；MD(95%CI):-0.33(-0.62--0.05),t=-2.408,P=0.023]，PSQI 总分下降[6.60±3.17 vs.4.03±2.58;MD(95%CI):-2.57(-3.87--1.27),t=-4.039,P
[Effects of Total Intravenous Anesthesia on Circadian Rhythms in Patients Undergoing Cardiac Transcatheter Closure].
Objective To evaluate the effects of total intravenous anesthesia on the circadian rhythms in the patients undergoing cardiac transcatheter closure. Methods Thirty patients undergoing cardiac transcatheter closure under elective intravenous anesthesia were included in this study.Paired t-tests were performed to compare the mRNA levels of the genes encoding circadian locomotor output cycles kaput(CLOCK),brain and muscle ARNT-1 like protein-1(BMAL1),cryptochrome 1(CRY1),and period circadian clock 2(PER2),the Munich Chronotype Questionnaire(MCTQ)score,and the Pittsburgh Sleep Quality Index(PSQI)score before and after anesthesia.Multiple stepwise regression analysis was performed to screen the factors influencing sleep chronotype and PSQI total score one week after surgery. Results The postoperative mRNA level of CLOCK was higher [1.38±1.23 vs.1.90±1.47;MD(95%CI):0.52(0.20-0.84),t=3.327,P=0.002] and the postoperative mRNA levels of CRY1 [1.56±1.50 vs.1.13±0.98;MD(95%CI):-0.43(-0.81--0.05),t=-2.319,P=0.028] and PER2 [0.82±0.63 vs.0.50±0.31;MD(95%CI):-0.33(-0.53--0.12),t=-3.202,P=0.003] were lower than the preoperative levels.One week after surgery,the patients presented advanced sleep chronotype [3:03±0:59 vs.2:42±0:37;MD(95%CI):-21(-40--1),t=-2.172,P=0.038],shortened sleep latency [(67±64)min vs.(37±21)min;MD(95%CI):-30.33(-55.28--5.39),t=-2.487,P=0.019],lengthened sleep duration [(436±83)min vs.(499±83)min;MD(95%CI):62.80(26.93-98.67),t=3.581,P=0.001],increased sleep efficiency [(87.59±10.35)% vs.(92.98±4.27)%;MD(95%CI):5.39(1.21-9.58),t=2.636,P=0.013],decreased sleep quality score [1.13±0.78 vs.0.80±0.71;MD(95%CI):-0.33(-0.62--0.05),t=-2.408,P=0.023],and declined PSQI total score [6.60±3.17 vs.4.03±2.58;MD(95%CI):-2.57(-3.87--1.27),t=-4.039,P<0.001].Body mass index(BMI)(B=-227.460,SE=95.475,t=-2.382,P=0.025),anesthesia duration(B=-47.079,SE=18.506,t=-2.544,P=0.017),and mRNA level of PER2(B=2815.804,SE=1080.183,t=2.607,P=0.015)collectively influenced the sleep chronotype,and the amount of anesthesia medicine(B=0.067,SE=0.028,t=2.385,P=0.024)independently influenced the PSQI one week after surgery. Conclusion Total intravenous anesthesia can improve sleep habits by advancing sleep chronotype.BMI,anesthesia duration,and mRNA level of PER2 collectively influence sleep chronotype one week after surgery.The amount of anesthesia medicine independently influences the PSQI total score one week after surgery.
期刊介绍：
Acta Academiae Medicinae Sinicae was founded in February 1979. It is a comprehensive medical academic journal published in China and abroad, supervised by the Ministry of Health of the People's Republic of China and sponsored by the Chinese Academy of Medical Sciences and Peking Union Medical College.
The journal mainly reports the latest research results, work progress and dynamics in the fields of basic medicine, clinical medicine, pharmacy, preventive medicine, biomedicine, medical teaching and research, aiming to promote the exchange of medical information and improve the academic level of medicine. At present, the journal has been included in 10 famous foreign retrieval systems and their databases [Medline (PubMed online version), Elsevier, EMBASE, CA, WPRIM, ExtraMED, IC, JST, UPD and EBSCO-ASP]; and has been included in important domestic retrieval systems and databases [China Science Citation Database (Documentation and Information Center of the Chinese Academy of Sciences), China Core Journals Overview (Peking University Library), China Science and Technology Paper Statistical Source Database (China Science and Technology Core Journals) (China Institute of Scientific and Technological Information), China Science and Technology Journal Paper and Citation Database (China Institute of Scientific and Technological Information)].
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
