基于褪黑素昼夜节律与抗炎通路探讨环泊酚改善老年患者术后睡眠质量的临床及机制研究

注册号:

Registration number:

ChiCTR2600121959 

最近更新日期:

Date of Last Refreshed on:

2026-04-07 16:52:57 

注册时间:

Date of Registration:

2026-04-07 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

基于褪黑素昼夜节律与抗炎通路探讨环泊酚改善老年患者术后睡眠质量的临床及机制研究

Public title:

Melatonin Circadian Rhythms and Anti-inflammatory Pathways: A Clinical and Mechanistic Study on Ciprofol's Improvement of Postoperative Sleep Quality in Elderly Patients

注册题目简写:

English Acronym:

研究课题的正式科学名称:

基于褪黑素昼夜节律与抗炎通路探讨环泊酚改善老年患者术后睡眠质量的临床及机制研究

Scientific title:

Melatonin Circadian Rhythms and Anti-inflammatory Pathways: A Clinical and Mechanistic Study on Ciprofol's Improvement of Postoperative Sleep Quality in Elderly Patients

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:

刘继明 

研究负责人:

刘继明 

Applicant:

Liu Jiming 

Study leader:

Liu Jiming 

申请注册联系人电话:

Applicant telephone:

+86 189 8430 8266

研究负责人电话:

Study leader's
telephone:

+86 189 8430 8266

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:

sunly310@163.com

研究负责人电子邮件:

Study leader's E-mail:

sunly310@163.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:

贵州省贵阳市白云区刚玉街108号

研究负责人通讯地址:

贵州省贵阳市白云区刚玉街108号

Applicant address:

No. 108, Corundum Street, Baiyun District, Guiyang City, Guizhou Province

Study leader's address:

No. 108, Corundum Street, Baiyun District, Guiyang City, Guizhou Province

申请注册联系人邮政编码:

Applicant postcode:

550014

研究负责人邮政编码:

Study leader's postcode:

550014

申请人所在单位:

贵州医科大学附属白云医院

Applicant's institution:

Baiyun Hospital Affiliated to Guizhou Medical University

研究负责人所在单位:

贵州医科大学附属白云医院

Affiliation of the Leader:

Baiyun Hospital Affiliated to Guizhou Medical University

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:

2026伦审第(2)号

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:

贵州医科大学附属白云医院伦理委员会

Name of the ethic committee:

Ethics Committee of Baiyun Hospital affiliated to Guizhou Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2026-03-04 00:00:00

伦理委员会联系人:

陈德凤

Contact Name of the ethic committee:

Dengfeng Chen

伦理委员会联系地址:

贵州省贵阳市白云区刚玉街108号

Contact Address of the ethic committee:

No. 108, Corundum Street, Baiyun District, Guiyang City, Guizhou Province

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 136 3912 9296

伦理委员会联系人邮箱:

Contact email of the ethic committee:

750863226@qq.com

研究实施负责(组长)单位:

贵州医科大学附属白云医院

Primary sponsor:

Baiyun Hospital Affiliated to Guizhou Medical University

研究实施负责(组长)单位地址:

贵州省贵阳市白云区刚玉街108号

Primary sponsor's address:

No. 108, Corundum Street, Baiyun District, Guiyang City, Guizhou 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):

贵州

市(区县):

贵阳

Country:

China

Province:

Guizhou

City:

Guiyang

单位(医院):

贵州医科大学附属白云医院

具体地址:

贵州省贵阳市白云区刚玉街108号

Institution
hospital:

Baiyun Hospital Affiliated to Guizhou Medical University

Address:

No. 108, Corundum Street, Baiyun District, Guiyang City, Guizhou Province

经费或物资来源:

北京康盟慈善基金会

Source(s) of funding:

Beijing Kangmeng Charity Foundation

研究疾病:

术后睡眠障碍  

Target disease:

(Postoperative Sleep Disturbance, POSD)

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:

IV期临床试验 

Study phase:

4

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

1.明确临床获益 通过多导睡眠监测(PSG)或医疗级可穿戴设备,客观量化对比环泊酚与丙泊酚全凭静脉麻醉对老年患者术后短期(术后1-3天)睡眠结构(重点关注睡眠效率、REM睡眠占比、睡眠片段化指数)的影响,明确环泊酚在改善POSD方面的临床优势。 2.阐释节律机制 通过动态监测围术期血清褪黑素(Melatonin)及皮质醇(Cortisol)的分泌曲线,分析环泊酚对老年患者昼夜节律相位的保护作用。 3.揭示抗炎通路 检测外周血神经炎症相关因子(IL-6, TNF-α, BDNF)水平,探讨“麻醉药物-炎症反应-睡眠质量”三者之间的相关性,验证环泊酚是否通过减轻围术期神经炎症来改善睡眠。 4.关联临床预后 初步探索环泊酚改善术后睡眠质量与降低术后谵妄(POD)发生率、加速术后康复(缩短住院日)之间的潜在联系,为优化老年患者麻醉方案提供循证医学证据。  

Objectives of Study:

1. Elucidate Clinical Benefits To objectively quantify and compare the effects of total intravenous anesthesia with Ciprofol versus Propofol on the short-term (postoperative days 1-3) sleep architecture of elderly patients, utilizing polysomnography (PSG) or medical-grade wearable devices. The focus will be on key parameters including sleep efficiency, REM sleep percentage, and sleep fragmentation index, thereby clarifying the clinical advantages of Ciprofol in improving Postoperative Sleep Disturbance (POSD). 2. Elucidate Circadian Mechanisms To analyze the protective effect of Ciprofol on the circadian rhythm phase in elderly patients by dynamically monitoring the secretion curves of serum melatonin and cortisol during the perioperative period. 3. Unravel Anti-inflammatory Pathways To investigate the correlation among "anesthetic agent - inflammatory response - sleep quality" by measuring levels of neuroinflammation-related factors (IL-6, TNF-α, BDNF) in peripheral blood, verifying whether Ciprofol improves sleep by attenuating perioperative neuroinflammation. 4. Correlate with Clinical Outcomes To preliminarily explore the potential link between Ciprofol-induced improvement in postoperative sleep quality and the reduction in the incidence of Postoperative Delirium (POD), as well as the acceleration of postoperative recovery (shortened hospital stay), thereby providing evidence-based medical support for optimizing anesthesia protocols in elderly patients.

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.睡眠基础疾病:既往确诊严重睡眠障碍(如重度失眠、严重的阻塞性睡眠呼吸暂停OSA且未治疗); 2.药物干扰:术前3个月内长期服用镇静催眠药(苯二氮卓类)、抗抑郁药或皮质类固醇激素; 3.神经精神病史:既往有脑卒中、阿尔茨海默病、帕金森病或精神分裂症病史; 4.特殊习惯:有跨时区旅行史(近1周内)或长期夜班工作史(昼夜节律紊乱者); 5.严重并发症:严重的肝肾功能不全(Child-Pugh C级或肌酐清除率<30ml/min); 6.过敏禁忌:对大豆油、鸡蛋、乳制品或丙泊酚/环泊酚成分过敏者。

Exclusion criteria:

1. Pre-existing Sleep Disorders: History of diagnosed severe sleep disorders (e.g., severe insomnia, untreated severe Obstructive Sleep Apnea (OSA)). 2. Medication Interference: Long-term use of sedative-hypnotics (e.g., benzodiazepines), antidepressants, or corticosteroids within 3 months prior to surgery. 3. Neuropsychiatric History: History of stroke, Alzheimer's disease, Parkinson's disease, or schizophrenia. 4. Specific Habits: History of transmeridian travel (within the past week) or long-term night shift work (indicative of circadian rhythm disruption). 5. Severe Comorbidities: Severe hepatic or renal insufficiency (Child-Pugh Class C or creatinine clearance <30 ml/min). 6. Allergies/Contraindications: Known allergy to soybean oil, eggs, dairy products, or any component of propofol/ciprofol.

研究实施时间:

Study execute time:

From 2026-04-07 00:00:00 To 2028-04-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-04-07 00:00:00 To 2028-04-30 00:00:00

干预措施:

Interventions:

组别:

试验组(环泊酚组,C组)

样本量:

68

Group:

Experimental Group (Ciprofol Group, Group C)

Sample size:

干预措施:

诱导:静脉注射 环泊酚 0.4 -0.5 mg/kg。 维持:环泊酚 0.8 - 3.0 mg/(kg·h) 持续泵注

干预措施代码:

Intervention:

Induction: Intravenous injection of ciprofol 0.4 - 0.5 mg/kg. Maintenance: Continuous infusion of ciprofol at 0.8 - 3.0 mg/(kg·h).

Intervention code:

组别:

对照组(丙泊酚组,P组)

样本量:

68

Group:

Control Group (Propofol Group, Group P)

Sample size:

干预措施:

诱导:静脉注射 丙泊酚 1.5 - 2.5 mg/kg。 维持:丙泊酚 4.0 - 12.0 mg/(kg·h) 持续泵注。

干预措施代码:

Intervention:

Induction: Intravenous injection of propofol 1.5 - 2.5 mg/kg. Maintenance: Continuous infusion of propofol at 4.0 - 12.0 mg/(kg·h).

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

贵州 

市(区县):

贵阳 

Country:

China

Province:

Guizhou

City:

Guiyang

单位(医院):

贵州医科大学附属白云医院 

单位级别:

三级 

Institution
hospital:

Baiyun Hospital Affiliated to Guizhou Medical University

Level of the institution:

Tertiary

测量指标:

Outcomes:

指标中文名:

术后第一晚的客观睡眠效率

指标类型:

主要指标

Outcome:

(Sleep Efficiency, SE)

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

睡眠结构参数

指标类型:

次要指标

Outcome:

Sleep Architecture Parameters

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

昼夜节律与分子机制指标

指标类型:

次要指标

Outcome:

Circadian Rhythm and Molecular Mechanism Metrics

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

临床预后指标

指标类型:

次要指标

Outcome:

Clinical Prognostic Indicators

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

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:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 65 years
最大 Max age 85 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):

分层随机化:为消除手术创伤类型(内脏痛 vs 躯体痛)的混杂影响,采用分层区组随机法。以“手术科室(腹部/骨科/盆腔)”为分层因素,利用SAS 9.4 生成随机序列,按 1:1 比例分入两组。

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

Stratified randomization was employed to control for the confounding effect of surgical trauma type (visceral vs. somatic pain). Using "surgical department (abdominal, orthopedic, or pelvic)" as the stratification factor, a blocked randomization sequence was generated with SAS 9.4 to allocate participants equally (1:1 ratio) into the two groups.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

双盲设计:由非项目组麻醉护士根据随机号配置药物,使用不透明遮光注射泵。 受试者盲:患者不知晓药物类型。 评估者盲:负责术后随访、睡眠数据读取及血样检测的研究人员完全不知晓分组。

Blinding:

Double-Blind Design: An anesthesia nurse, not involved in the study, prepared the medications according to the randomization codes and administered them using opaque, light-blocking syringe pumps to ensure blinding. Patient Blinding: The patients were unaware of their assigned drug type. Assessor Blinding: The researchers responsible for postoperative follow-up, sleep data analysis, and blood sample testing were completely blinded to the group assignments.

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

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):

论文发表后,通过ResMan(www.medresman.org.cn)方式共享。

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

After publication, the paper will be shared through ResMan (www.medresman.org.cn).

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:

CRF;EDC

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

CRF;EDC

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2026-04-07 16:52:44