体外循环心脏手术中血小板激活水平与术后谵妄相关性的临床与机制研究

注册号:

Registration number:

ChiCTR2600123349 

最近更新日期:

Date of Last Refreshed on:

2026-04-24 22:08:35 

注册时间:

Date of Registration:

2026-04-24 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

体外循环心脏手术中血小板激活水平与术后谵妄相关性的临床与机制研究

Public title:

Clinical and Mechanistic Study on the Association Between Platelet Activation During Cardiopulmonary Bypass Cardiac Surgery and Postoperative Delirium

注册题目简写:

体外循环下心脏手术后谵妄与血小板的关系研究

English Acronym:

Study on the Relationship Between Platelets and Postoperative Delirium After Cardiac Surgery With Cardiopulmonary Bypass

研究课题的正式科学名称:

体外循环心脏手术中血小板激活水平与术后谵妄相关性的临床与机制研究

Scientific title:

Clinical and Mechanistic Study on the Association Between Platelet Activation During Cardiopulmonary Bypass Cardiac Surgery and Postoperative Delirium

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:

吴镜湘 

研究负责人:

吴镜湘 

Applicant:

Wu Jingxiang 

Study leader:

Wu Jingxiang 

申请注册联系人电话:

Applicant telephone:

+86 136 4162 9197

研究负责人电话:

Study leader's
telephone:

+86 21 2220 0000

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:

wjx1132@163.com

研究负责人电子邮件:

Study leader's E-mail:

wjx1132@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:

上海市淮海西路241号

研究负责人通讯地址:

上海市徐汇区淮海西路241号

Applicant address:

No. 241, Huaihai West Road, Shanghai, China

Study leader's address:

241 Huai Hai (W.) Rd Shanghai

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:

上海市胸科医院

Applicant's institution:

Shanghai Chest Hospital

研究负责人所在单位:

上海市胸科医院

Affiliation of the Leader:

Shanghai 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:

IS26021

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:

上海市胸科医院伦理委员会

Name of the ethic committee:

Ehtics Committee of Shanghai Chest Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2026-03-10 00:00:00

伦理委员会联系人:

陈仲林

Contact Name of the ethic committee:

Carlos

伦理委员会联系地址:

上海市徐汇区淮海西路241号

Contact Address of the ethic committee:

241 Huai Hai (W.) Rd Shanghai

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 21 2220 0000

伦理委员会联系人邮箱:

Contact email of the ethic committee:

chestgcp@126.com

研究实施负责(组长)单位:

上海市胸科医院

Primary sponsor:

Shanghai Chest Hospital

研究实施负责(组长)单位地址:

上海市徐汇区淮海西路241号

Primary sponsor's address:

241 Huai Hai (W.) Rd Shanghai

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

上海市

市(区县):

Country:

China

Province:

Shanghai

City:

单位(医院):

上海市胸科医院

具体地址:

上海市徐汇区淮海西路241号

Institution
hospital:

Shanghai Chest?Hospital

Address:

241 Huai Hai (W.) Rd?Shanghai

经费或物资来源:

自选课题(自筹)

Source(s) of funding:

Self-raised

研究疾病:

术后谵妄(Postoperative Delirium, POD)  

Target disease:

Postoperative delirium (POD)

研究疾病代码:

Target disease code:

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

队列研究 

Study design:

Cohort study 

研究目的:

旨在探索体外循环患者术中血小板激活对术后谵妄(POD)发生的影响,揭示其在POD发生中的作用。探索血小板在体外循环(CPB)期间激活引发的一系列代谢变化与术后谵妄(POD)的发生关系。为术后POD的早期干预提供参考依据,为临床预防和干预POD提供新的思路。  

Objectives of Study:

This study aims to explore the impact of intraoperative platelet activation on the occurrence of postoperative delirium (POD) in patients undergoing cardiopulmonary bypass (CPB), and to elucidate its role in the development of POD. It investigates the relationship between a series of metabolic changes induced by platelet activation during CPB and the onset of POD. The findings are expected to provide a reference for early intervention of POD and offer new strategies for its clinical prevention and management.

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. 术前MMSE评分<24分的患者; 2. 术前有严重精神病史或癫痫病史患者; 3. 术前14天内接受高剂量糖皮质激素或免疫抑制/生物制剂治疗的患者; 4. ALT/AST或TBi超过正常上限3倍的患者; 5. 血清肌酐超过正常上限2倍的患者; 6. 妊娠或哺乳期妇女; 7. 已明确存在其他血小板功能异常疾病患者; 8. 不愿意参与研究或无法签署知情同意书的患者; 9. 术后24~72小时内因各种原因无法进行CAM-ICU评估的患者。

Exclusion criteria:

1. Patients with a preoperative MMSE score <24; 2. Patients with a history of severe psychiatric disorders or epilepsy; 3. Patients who received high-dose glucocorticoids or immunosuppressive/biologic therapy within 14 days before surgery; 4. Patients with ALT, AST, or total bilirubin (TBi) exceeding three times the upper limit of normal; 5. Patients with serum creatinine exceeding twice the upper limit of normal; 6. Pregnant or breastfeeding women; 7. Patients with known platelet function disorders; 8. Patients unwilling to participate in the study or unable to provide informed consent; 9. Patients unable to undergo CAM-ICU assessment within 24–72 hours postoperatively for any reason.

研究实施时间:

Study execute time:

From 2026-03-30 00:00:00 To 2028-09-09 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-04-25 00:00:00 To 2028-09-09 00:00:00

干预措施:

Interventions:

组别:

POD-高危组

样本量:

150

Group:

POD-High risk

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

组别:

POD-低危组

样本量:

150

Group:

POD-low risk

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

上海市 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海市胸科医院 

单位级别:

三级甲等 

Institution
hospital:

Shanghai Chest?Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

血小板基础活化水平

指标类型:

主要指标

Outcome:

Baseline platelet activation level

Type:

Primary indicator

测量时间点:

切皮前5min和CPB开始后1小时

测量方法:

流式细胞术法

Measure time point of outcome:

5 min pre-incision and 1 h after CPB initiation

Measure method:

Flow cytometry analysis

指标中文名:

体温

指标类型:

次要指标

Outcome:

Core temperature

Type:

Secondary indicator

测量时间点:

切皮前5min和CPB开始后1小时

测量方法:

监护仪体温探头

Measure time point of outcome:

5 min pre-incision and 1 h after CPB initiation

Measure method:

emperature probe of the patient monitor

指标中文名:

异体血输注

指标类型:

次要指标

Outcome:

Intraoperativebloodtransfusion

Type:

Secondary indicator

测量时间点:

手术中及术后72小时

测量方法:

记录输血总量及类型。采用有或者无来统计。有异体输血记为1,无异体输血记为0.

Measure time point of outcome:

During surgery and within 72 hours after surgery.

Measure method:

Record the total volume and type of transfusion. Use a binary variable: 1 for any allogeneic transfusion, 0 for no allogeneic transfusion.

指标中文名:

血小板ADP反应

指标类型:

主要指标

Outcome:

Platelet response to ADP

Type:

Primary indicator

测量时间点:

切皮前5min和CPB开始后1小时

测量方法:

流式细胞术法

Measure time point of outcome:

5 min pre-incision and 1 h after CPB initiation

Measure method:

Flow cytometry analysis

指标中文名:

5-HT

指标类型:

次要指标

Outcome:

5-HT

Type:

Secondary indicator

测量时间点:

切皮前5min和CPB开始后1小时

测量方法:

ELAS法

Measure time point of outcome:

5 min pre-incision and 1 h after CPB initiation

Measure method:

ELAS

指标中文名:

IL-6

指标类型:

次要指标

Outcome:

IL-6

Type:

Secondary indicator

测量时间点:

切皮前5min和CPB开始后1小时

测量方法:

ELSA

Measure time point of outcome:

5 min pre-incision and 1 h after CPB initiation

Measure method:

ELSA

指标中文名:

血小板LC-MS代谢物

指标类型:

次要指标

Outcome:

Platelet metabolites detected by LC-MS

Type:

Secondary indicator

测量时间点:

切皮前5min和CPB开始后1小时

测量方法:

LC-MS

Measure time point of outcome:

5 min pre-incision and 1 h after CPB initiation

Measure method:

LC-MS

指标中文名:

术前使用抗血小板药物

指标类型:

次要指标

Outcome:

Preoperative use of antiplatelet drugs

Type:

Secondary indicator

测量时间点:

术前14天内

测量方法:

询问病史,查阅病例治疗

Measure time point of outcome:

During the 14-day preoperative period

Measure method:

Collection of medical history and review of clinical records

指标中文名:

CAM-ICU评估结果

指标类型:

主要指标

Outcome:

CAM-ICU–based delirium assessment outcomes

Type:

Primary indicator

测量时间点:

术后24-72小时,必要时延后至术后7天

测量方法:

CAM-ICU量表评估

Measure time point of outcome:

24–72 hours postoperatively

Measure method:

CAM-ICU–based assessment

指标中文名:

TXA2

指标类型:

次要指标

Outcome:

TXA2

Type:

Secondary indicator

测量时间点:

切皮前5min和CPB开始后1小时

测量方法:

ELSA

Measure time point of outcome:

5 min pre-incision and 1 h after CPB initiation

Measure method:

ELSA

指标中文名:

平均动脉压

指标类型:

次要指标

Outcome:

MAP

Type:

Secondary indicator

测量时间点:

切皮前5min和CPB开始后1小时

测量方法:

术中监测连续动脉压

Measure time point of outcome:

5 min pre-incision and 1 h after CPB initiation

Measure method:

Intraoperative continuous arterial pressure monitoring

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 18 years
最大 Max age 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):

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

None

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:

Blinding:

None

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):

本研究产生的所有原始数据将在去标识化处理后公开,以确保受试者隐私安全。去标识化处理将删除所有可识别个人身份的信息,包括姓名、身份证号、联系方式及住院号等。去标识化后的数据将安全存储于本机构或公认的电子数据存储平台。仅允许经过资格审核并签署数据使用协议的研究者访问数据。数据仅用于学术研究和科研目的,严禁任何重新识别受试者或用于商业用途的行为。数据将根据机构规定保存[5年]。

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

All raw data generated in this study will be de-identified to ensure participant privacy, with removal of all personally identifiable information, including names, ID numbers, contact information, and hospital identifiers. The de-identified data will be securely stored in an institutional or recognized electronic data repository. Access to the data will be granted only to qualified researchers who have submitted a formal request and signed a data use agreement. The data are intended solely for academic and research purposes, and any attempt to re-identify participants or use the data for commercial purposes is strictly prohibited. The data will be retained for a period of [5 years] in accordance with institutional policies.

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:

病例记录表(CRF, Case Report Form):通过术前访谈、病历查阅、术中监测及实验室检测等方式收集数据,包括人口学信息、病史、术中血小板功能及代谢指标、术后谵妄评估结果等。所有信息将记录在标准化的纸质和电子病例记录表中,并采用预设编码管理,确保患者信息安全。 电子数据采集和管理系统(EDC, Electronic Data Capture System):收集的病例记录表数据将同步录入加密的电子数据库,由授权研究人员访问。系统设有访问控制、活动日志和定期备份机制,以确保数据完整性、可追溯性和安全性。所有数据在录入后进行去标识化处理,删除姓名、身份证号、联系方式及住院号等可识别个人信息。数据仅用于本研究及经批准的学术研究目的,禁止商业使用或试图重新识别受试者

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

Case Report Form (CRF):Data will be collected through preoperative interviews, review of medical records, intraoperative monitoring, and laboratory measurements, including demographic information, medical history, intraoperative platelet function and metabolite data, and postoperative delirium assessment results.All information will be recorded in standardized paper or electronic case report forms, managed with pre-assigned codes to ensure patient confidentiality. Electronic Data Capture and Management System (EDC):Data from the case report forms will be entered into a secure, encrypted electronic database or institution-approved server, accessible only to authorized research personnel.The system will implement access controls, activity logs, and regular backups to ensure data integrity, traceability, and security.All data will be de-identified, removing personally identifiable information such as names, ID numbers, contact details, and hospital identifiers.Data will be used solely for this study and approved academic research purposes. Commercial use or attempts to re-identify participants are strictly prohibited.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

无/No

注册人:

Name of Registration:

 2026-04-24 22:08:26