[1]甘惠 伍姿 石迎春 刘余 杨政伟.生物标志物用于老年髋部骨折患者谵妄风险预测的研究进展[J].中华老年骨科与康复电子杂志,2025,(06):379-384.[doi:10.3877/cma.j.issn.2096-0263.2025.06.009]
　Gan Hui,Wu Zi,Shi Yingchun,et al.Research advances in biomarkers for predicting delirium risk in elderly patients with hip fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2025,(06):379-384.[doi:10.3877/cma.j.issn.2096-0263.2025.06.009]
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生物标志物用于老年髋部骨折患者谵妄风险预测的研究进展()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2025年06期
页码:
379-384
栏目:
出版日期:
2025-12-05

文章信息/Info

Title:
Research advances in biomarkers for predicting delirium risk in elderly patients with hip fractures
作者:
甘惠 伍姿 石迎春 刘余 杨政伟
402360 重庆市大足区中医院骨伤科
Author(s):
Gan Hui;  Wu Zi;  Shi Yingchun;  Liu Yu;  Yang Zhengwei
Department of Orthopedics and Traumatology, Chongqing Dazu District Hospital of Traditional Chinese Medicine, Chongqing 402360, China
关键词:
髋部骨折;  谵妄;  生物标志物;  血生化指标;  炎症标志物
Keywords:
Hip Fracture;  Delirium; Biomarker;  Plasma Biochemical Indicators;  Inflammatory Marker;  Cerebrospinal Fluid Markers;  Scoping Review
DOI:
10.3877/cma.j.issn.2096-0263.2025.06.009
文献标志码:
A
摘要:
目的 系统综述髋部骨折患者谵妄风险预测的生物标志物研究进展，明确其概念、分类及临床应用价值，为早期识别高危患者及实施精准干预提供理论依据。方法 全面检索英文数据库Pub Med、Cochrane Library、Web of Science、CINAHL、Embase，中文数据库CNKI、CBM、维普期刊平台、万方数据知识服务平台，涵盖各数据库自建库之初至2024年12月所有文献。由2名研究者独立筛选文献、评估质量并提取数据后，对纳入文献进行汇总分析。结果 共纳入19篇文献，涵盖3大类生物标志物：1.炎症标志物：中性粒细胞与淋巴细胞比值（NLR）、全身免疫炎症指数（SII）、C反应蛋白（CRP）及细胞因子（IL-6、TNF-α）与谵妄风险显著相关；2.血生化标志物：血清白蛋白、血清S100钙结合蛋白A12（S100A12）及血清神经丝轻链蛋白（NfL）通过反映营养状态及中枢神经损伤预测谵妄风险；3.脑脊液标志物：基质金属蛋白酶组织抑制剂（TIMP-1）和可溶性髓系细胞触发受体2（sTREM2）可能通过神经炎症途径参与谵妄发生。 结论 现有证据支持生物标志物对髋部骨折患者谵妄风险的预测价值，但存在三大局限：1.各研究临界值差异大（如NLR界值）；2.缺乏动态监测数据；3.多标志物联合预测模型研究不足。建议未来开展多中心前瞻性研究，结合多标志物联合预测模型，并制定基于循证的临床应用指南推进生物标志物谵妄风险预测的临床转化。
Abstract:
Objective To systematically review the research progress on biomarkers for delirium risk prediction in hip fracture patients, clarify their concepts, classifications, and clinical application value, and provide a theoretical basis for early identification of high-risk patients and precise intervention. Methods Relevant studies were systematically searched in databases including PubMed, Cochrane Library, Web of Science, CINAHL, Embase, CNKI, VIP, Wanfang, and CBM, with the search timeframe spanning from database inception to December 31, 2024. Two researchers independently screened the literature, assessed quality, and extracted data, followed by a summarized analysis of the included studies. Results A total of 19 studies were included, covering three major categories of biomarkers: 1. Inflammatory markers: Neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), C-reactive protein (CRP), and cytokines (IL-6, TNF-α) were significantly associated with delirium risk; 2. Blood biochemical markers: Serum albumin, serum S100 calcium-binding protein A12 (S100A12), and serum neurofilament light chain protein (NfL) predicted delirium risk by reflecting nutritional status and central nervous system injury; 3. Cerebrospinal fluid markers: Tissue inhibitor of metalloproteinases-1 (TIMP-1) and soluble triggering receptor expressed on myeloid cells 2 (sTREM2) may contribute to delirium onset through neuroinflammatory pathways. Conclusion Current evidence supports the predictive value of biomarkers for delirium risk in hip fracture patients, but three major limitations exist: 1. Significant variability in cutoff values across studies (e.g., NLR thresholds); 2. Lack of dynamic monitoring data; 3. Insufficient research on multi-biomarker combined prediction models. Future multicenter prospective studies are recommended to develop combined biomarker prediction models and establish evidence-based clinical guidelines to facilitate the translation of biomarker-based delirium risk prediction into clinical practice.

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备注/Memo

备注/Memo:
基金项目：重庆市科卫联合医学项目（2025QNXM020）
更新日期/Last Update: 2026-05-18