Correlation analysis between ferroptosis in peripheral blood mononuclear cells and postoperative delirium in patients with hypertensive intracerebral hemorrhage
Zhang Xungong
Yang Guanghui
Du Zengli
Xue Pei
Abstract：Objective To investigate the correlation between ferroptosis in peripheral blood mononuclear cells(PBMC)and the occurrence of postoperative delirium in patients with hypertensive intracerebral hemorrhage(HICH).Methods Clinical data of 162 HICH patients who underwent surgical treatment were analyzed retrospectively.Based on whether postoperative delirium occurred within one week after surgery,the patients were divided into a control group(n=110,without postoperative delirium)and an observation group(n=52,with postoperative delirium).Baseline data,as well as levels of S100 calcium-binding protein β(S100-β),neuron-specific enolase(NSE),long-chain acyl-CoA synthetase 4(ACSL4),glutathione peroxidase 4(GPX4),and ferritin in PBMCs,were compared between the two groups.Binary logistic regression analysis was used to identify risk factors influencing the occurrence of postoperative delirium in HICH patients.Pearson correlation analysis was employed to assess the correlation between the levels of ACSL4,GPX4,and ferritin in PBMCs and the levels of S100-β and NSE in HICH patients.The receiver operator characteristic(ROC)curve was used to analyze the clinical value of ACSL4,GPX4,and ferritin levels in PBMCs in predicting postoperative delirium in HICH patients.Results Univariate analysis and binary logistic regression analysis revealed that a large volume of cerebral hemorrhage,low GPX4 levels,and high ACSL4 and ferritin levels were independent risk factors for the occurrence of postoperative delirium in HICH patients(all P<0.05).Pearson correlation analysis showed positive correlations between ACSL4 and ferritin levels in PBMCs and S100-β and NSE levels in HICH patients,while GPX4 levels were negatively correlated with S100-β and NSE levels(all P<0.001).ROC analysis indicated that the optimal cut-off values for predicting postoperative delirium in HICH patients were≥192.90 μg/L for ACSL4,≤25.65 μg/L for GPX4,and≥14.30 μg/L for ferritin in PBMCs,with area under the curve values of 0.863,0.857,and 0.796,respectively,sensitivities of 71.15%,92.31%,and 75.00%,and specificities of 88.18%,68.18%,and 72.73%,respectively.Conclusions The levels of ACSL4,GPX4,and ferritin in PBMCs can effectively reflect the degree of neurological injury in HICH patients and have certain value in predicting the occurrence of postoperative delirium.
Keywords：intracranial hemorrhagehypertensivedelirious speechperipheral blood mononuclear cellsferroptosis
Publication Date：2025-07-20
Online Publishing Date：2025-08-21(First online date of this platform, not the publication date of the document)
Pages：5( 408-412 )