奥赛利定对老年患者脊柱结核手术术后镇痛、免疫功能以及术后谵妄影响的研究

注册号:

Registration number:

ChiCTR2500115441 

最近更新日期:

Date of Last Refreshed on:

2025-12-26 08:42:27 

注册时间:

Date of Registration:

2025-12-26 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

奥赛利定对老年患者脊柱结核手术术后镇痛、免疫功能以及术后谵妄影响的研究

Public title:

Study on the Effects of Oliceridine on Postoperative Analgesia, Immune Function, and Postoperative Delirium in Elderly Patients Undergoing Spinal Tuberculosis Surgery

注册题目简写:

English Acronym:

研究课题的正式科学名称:

奥赛利定对老年患者脊柱结核手术术后镇痛、免疫功能以及术后谵妄影响的研究

Scientific title:

Study on the Effects of Oliceridine on Postoperative Analgesia, Immune Function, and Postoperative Delirium in Elderly Patients Undergoing Spinal Tuberculosis Surgery

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

赵子军 

研究负责人:

赵子军 

Applicant:

Zhao Zijun 

Study leader:

Zhao Zijun 

申请注册联系人电话:

Applicant telephone:

+86 311 86911232

研究负责人电话:

Study leader's
telephone:

+86 311 86911232

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

86231721@qq.com

研究负责人电子邮件:

Study leader's E-mail:

86231721@qq.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

河北省石家庄市长安区胜利北街372号

研究负责人通讯地址:

河北省石家庄市长安区胜利北街372号

Applicant address:

No. 372, Shengli North Street, Chang'an District, Shijiazhuang City, Hebei Province

Study leader's address:

No. 372, Shengli North Street, Chang'an District, Shijiazhuang City, Hebei Province

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

河北省胸科医院

Applicant's institution:

Hebei Chest Hospital

研究负责人所在单位:

河北省胸科医院

Affiliation of the Leader:

Hebei Chest Hospital

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2025120

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

河北省胸科医院伦理委员会

Name of the ethic committee:

Ethics Committee of Hebei Chest Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2025-11-11 00:00:00

伦理委员会联系人:

刘孟佳

Contact Name of the ethic committee:

Liu Mengjia

伦理委员会联系地址:

河北省石家庄市长安区胜利北街372号

Contact Address of the ethic committee:

No. 372, Shengli North Street, Chang'an District, Shijiazhuang City, Hebei Province

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 311 86911366

伦理委员会联系人邮箱:

Contact email of the ethic committee:

1059546617@qq.com

研究实施负责(组长)单位:

河北省胸科医院

Primary sponsor:

Hebei Chest Hospital

研究实施负责(组长)单位地址:

河北省石家庄市长安区胜利北街372号

Primary sponsor's address:

No. 372, Shengli North Street, Chang'an District, Shijiazhuang City, Hebei Province

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

河北省

市(区县):

Country:

China

Province:

Hebei

City:

单位(医院):

河北省胸科医院

具体地址:

河北省石家庄市长安区胜利北街372号

Institution
hospital:

Hebei Chest Hospital

Address:

No. 372, Shengli North Street, Chang'an District, Shijiazhuang City, Hebei Province

经费或物资来源:

政府资助临床医学优秀人才培养项目

Source(s) of funding:

Government-Funded Outstanding Clinical Medical Talent Training Program

研究疾病:

脊柱结核患者术后疼痛、免疫功能以及谵妄情况  

Target disease:

Postoperative Pain, Immunological Status, and Delirium in Patients Following Spinal Tuberculosis Surgery

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

上市后药物 

Study phase:

4

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

本研究旨在评估新型G蛋白偏向性μ阿片受体激动剂奥赛利定(Oliceridine)用于老年脊柱结核手术患者术后镇痛的效果与安全性。通过与传统的舒芬太尼进行前瞻性随机对照比较,核心目标是探究奥赛利定能否在提供有效镇痛的同时,减轻对患者免疫功能的抑制(通过监测T细胞亚群、炎症因子等指标),并降低术后谵妄的发生率。研究期望为这一高危人群找到一种能兼顾“镇痛-免疫保护-神经保护”的优化镇痛方案,为临床实践提供高级别循证依据。  

Objectives of Study:

This study aims to evaluate the efficacy and safety of the novel G protein-biased μ-opioid receptor agonist, oliceridine, for postoperative analgesia in elderly patients undergoing spinal tuberculosis surgery. Through a prospective randomized controlled comparison with traditional sufentanil, the core objective is to investigate whether oliceridine can provide effective analgesia while mitigating the suppression of patients' immune function (by monitoring T cell subsets, inflammatory factors, and other indicators) and reducing the incidence of postoperative delirium. The study hopes to identify an optimized analgesic regimen that balances "analgesia, immune protection, and neuroprotection" for this high-risk patient population, thereby providing high-level evidence-based support for clinical practice.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.严重心肺功能障碍、肝肾功能不全(Child-Pugh C级、肾小球滤过率(eGFR)<30 mL/min/1.73m²);长期使用免疫抑制剂或合并其他免疫疾病如HIV感染、活动性病毒性肝炎、自身免疫性疾病(如系统性红斑狼疮、类风湿性关节炎等);术前1月内发生急性结核播散(如粟粒性肺结核、结核性脑膜炎)或咯血量>50 mL/日;已知对阿片类药物(舒芬太尼、奥赛利定)过敏或存在使用禁忌;妊娠或哺乳期妇女;术前1月内参与其他临床试验;存在认知障碍或语言障碍,无法配合相关评估者;药物/酒精依赖史等。

Exclusion criteria:

1.Severe cardiopulmonary dysfunction, hepatic or renal insufficiency (Child‑Pugh Class C, estimated glomerular filtration rate [eGFR] <30 mL/min/1.73m²). Long‑term use of immunosuppressants or coexisting immune‑related diseases such as HIV infection, active viral hepatitis, or autoimmune disorders (e.g., systemic lupus erythematosus, rheumatoid arthritis). Acute dissemination of tuberculosis within 1 month before surgery (e.g., miliary tuberculosis, tuberculous meningitis) or hemoptysis >50 mL/day. Known allergy or contraindication to opioid medications (e.g., sufentanil, oliceridine). Pregnancy or lactation. Participation in another clinical trial within 1 month prior to surgery. Cognitive or language impairment that would preclude compliance with study assessments. History of drug or alcohol dependence.

研究实施时间:

Study execute time:

From 2026-01-01 00:00:00 To 2027-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-01-01 00:00:00 To 2026-09-30 00:00:00

干预措施:

Interventions:

组别:

舒芬太尼组

样本量:

54

Group:

Sufentanil group

Sample size:

干预措施:

术后使用舒芬太尼进行持续镇痛

干预措施代码:

Intervention:

Postoperative continuous analgesia with Sufentanil.

Intervention code:

组别:

奥赛利定组

样本量:

54

Group:

Oliceridine group

Sample size:

干预措施:

术后使用奥赛利定进行持续镇痛

干预措施代码:

Intervention:

Postoperative continuous analgesia with Oliceridine.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

河北省 

市(区县):

 

Country:

China

Province:

Hebei

City:

单位(医院):

河北省胸科医院 

单位级别:

三级甲等 

Institution
hospital:

Hebei Chest Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

S100β蛋白和神经烯醇化酶

指标类型:

次要指标

Outcome:

S100β protein and neuron-specific enolase

Type:

Secondary indicator

测量时间点:

麻醉前、术后24h、术后48h、术后72h

测量方法:

酶联免疫法法检测患者外周血

Measure time point of outcome:

Pre-anesthesia, and postoperatively at 24h, 48h, and 72h

Measure method:

Peripheral blood from patients was measured by ELISA

指标中文名:

术后谵妄发生率

指标类型:

次要指标

Outcome:

Postoperative delirium incidence rate

Type:

Secondary indicator

测量时间点:

术后24h、术后48h、术后72h

测量方法:

采用3分钟谵妄诊断量表(3D-CAM)对病人进行谵妄评估,该表通过对病人询问问题和观察其状态给出评估意见。该量表包含22个问题条目,分为四个特征,特征1和2均为阳性,加上特征3或4阳性,即诊断为谵妄。

Measure time point of outcome:

Postoperative 24h, 48h, and 72h

Measure method:

Delirium was assessed using the 3?Minute Diagnostic Interview for CAM?defined Delirium (3D?CAM). This instrument evaluates patients through a structured interview and observation of their state. It comprises 22 question items categorized into four features. A diagnosis of delirium is made if both Feature?1 and Feature?2 are positive, along with positivity in either Feature?3 or Feature?4.

指标中文名:

视觉模拟评分法

指标类型:

主要指标

Outcome:

Visual Analogue Scale

Type:

Primary indicator

测量时间点:

术后2h、术后6h、术后24h、术后48h 静息及咳嗽时

测量方法:

VAS评分0~10分,无痛为0分,无法忍受的疼痛为10分,1~3分:轻度疼痛,4~6分:中度疼痛,7~10分:重度疼痛,VAS评分≥4分定义为中重度疼痛。

Measure time point of outcome:

Postoperative 2h, 6h, 24h, and 48h at rest and during cough

Measure method:

Visual Analogue Scale (VAS) Pain Scoring Criteria: Score 0: No pain. Score 10: Unbearable pain. Scores 1–3: Mild pain. Scores 4–6: Moderate pain. Scores 7–10: Severe pain. A VAS score of ≥4 is defined as moderate-to-severe pain.

指标中文名:

CD3+百分率

指标类型:

次要指标

Outcome:

Percentage of CD3+ (cells)

Type:

Secondary indicator

测量时间点:

麻醉前、术后6h、术后24h、术后48h、术后72h

测量方法:

使用流式细胞仪检测患者外周血

Measure time point of outcome:

Pre-anesthesia, and postoperatively at 6h, 24h, 48h, and 72h

Measure method:

Flow cytometry was used to analyze the patient's peripheral blood.

指标中文名:

恶心呕吐、呼吸抑制、腹胀、便秘、头晕、瘙痒

指标类型:

次要指标

Outcome:

Nausea and vomiting, respiratory depression, abdominal distension, constipation, dizziness, pruritus.

Type:

Secondary indicator

测量时间点:

术后48小时内

测量方法:

采用标准化方法进行测量:恶心、头晕、瘙痒采用视觉模拟评分法;呕吐记录发作次数;呼吸抑制依据呼吸频率<8次/分和/或脉搏血氧饱和度<90%进行判定;腹胀通过患者主诉结合腹部叩诊及腹围测量评估;便秘定义为术后48小时内未排便。

Measure time point of outcome:

Within 48 hours after surgery.

Measure method:

Measurements were conducted using standardized methods: nausea, dizziness, and pruritus were assessed using the Visual Analog Scale (VAS); vomiting was recorded by counting the number of episodes; respiratory depression was defined as a respiratory rate <8 breaths per minute and/or pulse oxygen saturation (SpO?) <90%; abdominal distension was evaluated based on patient complaints combined with abdominal percussion and abdominal girth measurement; constipation was defined as the absence of defeca

指标中文名:

CD4+/CD8+比值

指标类型:

次要指标

Outcome:

CD4+/CD8+ ratio

Type:

Secondary indicator

测量时间点:

麻醉前、术后6h、术后24h、术后48h、术后72h

测量方法:

使用流式细胞仪检测患者外周血

Measure time point of outcome:

Pre-anesthesia, and postoperatively at 6h, 24h, 48h, and 72h

Measure method:

Flow cytometry was used to analyze the patient's peripheral blood.

指标中文名:

CD4+百分率

指标类型:

次要指标

Outcome:

Percentage of CD4+ (cells)

Type:

Secondary indicator

测量时间点:

麻醉前、术后6h、术后24h、术后48h、术后72h

测量方法:

使用流式细胞仪检测患者外周血

Measure time point of outcome:

Pre-anesthesia, and postoperatively at 6h, 24h, 48h, and 72h

Measure method:

Flow cytometry was used to analyze the patient's peripheral blood.

指标中文名:

白细胞介素-10、白细胞介素-6、肿瘤坏死因子-α、干扰素-γ

指标类型:

次要指标

Outcome:

IL-10, IL-6, TNF-α, IFN-γ

Type:

Secondary indicator

测量时间点:

麻醉前、术后6h、术后24h、术后48h、术后72h

测量方法:

酶联免疫法法检测患者外周血

Measure time point of outcome:

Pre-anesthesia, and postoperatively at 6h, 24h, 48h, and 72h

Measure method:

Peripheral blood from patients was measured by ELISA

指标中文名:

患者出院时认知情况

指标类型:

次要指标

Outcome:

Patient's cognitive status at discharge

Type:

Secondary indicator

测量时间点:

患者出院当天

测量方法:

所有患者于出院时进行MMSE测试,其测试内容为定向力(10分),语言能力(9分),注意力和计算力(5分),记忆力(3分),回忆能力(3分)。总分为30分,评分<24分被认为存在认知功能缺陷。

Measure time point of outcome:

Patient discharge day

Measure method:

All patients underwent the MMSE test at discharge. The test assessed the following domains: Orientation (10 points), Language Ability (9 points), Attention and Calculation (5 points), Memory (3 points), and Recall (3 points). The total score is 30 points, and a score below 24 is indicative of cognitive impairment.

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

Blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 60 years
最大 Max age 80 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

不参与后续研究的独立统计人员通过计算机随机产生随机号码

Randomization Procedure (please state who generates the random number sequence and by what method):

Random numbers were generated by computer by an independent statistician not involved in the subsequent study.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

双盲

Blinding:

Double blind

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

原始个体参与者数据将在主要研究结果发表后的 6个月 起开始提供共享,为期 1年。经合理请求并出于验证研究结果等符合伦理和科学的目的,可向主要研究者索取去标识化的个体数据。具体的共享方案将在试验结束后制定。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Individual participant data that underlie the results reported in the primary publication will be made available, beginning 6 months and ending 1 years after article publication. Data will be shared with researchers who provide a methodologically sound proposal for use in achieving the goals of the approved proposal (e.g., for verification of results or meta-analysis). Proposals should be directed to the corresponding author via email. Access will be granted after review and approval by the trial’s steering committee, subject to a signed data access agreement.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

本研究采用纸质病例报告表(Case Report Form, CRF) 进行原始数据采集。所有数据将由双人独立录入专用的电子数据库,并通过逻辑核查与人工比对确保数据质量。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Data collection and Management:This study will utilize paper-based Case Report Forms (CRFs) for primary data collection. All data will be independently double-entered into a dedicated electronic database. Data quality will be ensured through programmatic logic checks and manual source data verification.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

无/No

注册人:

Name of Registration:

 2025-12-26 08:42:08