摘要
目的观察老年手术患者血清内的神经元特异性烯醇化酶（NSE）、S100β蛋白（S100β）、B淀粉样蛋白（Aβ）在围术期的变化，探讨其与术后认知功能障碍（POCD）的关系。方法择期全麻手术患者30例，65-85岁，ASAⅠ或Ⅱ级。常规麻醉诱导后行气管插管，麻醉维持采用丙泊酚2～3mg／kg、瑞芬太尼6～10μg·kg^-1·h^-1，间断推注顺苯磺酸阿曲库铵并吸入七氟醚调整麻醉深度。分别于术前、术毕（以缝皮结束为术毕）、术毕30min、6、12h、1、2、3、4d从颈内静脉抽取3ml血液，ELISA法测定NSE、S100β和Aβ蛋白的含量。分别于术前和术后1d、5d和7d应用简易智力状态检查量表（MMSE）进行评分，评估POCD的发生情况。术后根据是否发生POCD分为POCD组和NPOCD组。结果与术前比较，术毕12h和1d患者血清NSE含量明显升高（P〈0．01或P〈0．05），术毕30min和6h S100β蛋白含量明显升高（P〈0．01或P〈0．05），术毕30min血清AG蛋白含量明显升高（P〈0．05）。与NPOCD组比较，术毕12h、1d和2d时POCD组血清NSE水平明显升高（P〈0．01或P〈0．05）；术毕30min和6h血清S100β蛋白含量明显升高（P〈0．01或P〈0．05）。两组血清Aβ蛋白含量差异无统计学意义。结论老年患者术后血清NSE、S100β和Aβ蛋白均升高，且POCD组NSE、S100β升高更明显。
Objective To investigate the time course of serum neuron-specific enolase （NSE）, S100β protein （S100β） and β-amyoid peptide （Aβ）in elderly patients undergoing operation, and to analyse their relationship with postoperative cognitive dysfunction （POCD）, as the evidence of the clinic. Methods The levels of serum NSE, S100B and A[3 were detected in 30 patients （older than 60 years） before and 30 rain, 6 h, 12 h, 1 d, 2 d, 3 d, 4 d after operation. Comparing these indexes, POCD was evaluated and the time course of NSE, S100β and Aβ were compared between the patients with or without POCD. Results Compared with pre-operation,NSE at 12 h and 1 d,S100β at 30 rain and 6 h after operation were increased significantly （P〈0.01 or P〈0. 05）. Compared with group NPOCD, NSE at 12 h, 1 d and 2 d, S100β at 30 min and 6 h after operation in group POCD were increased significantly （P〈0. 01 or P〈0. 05）. There was no difference in Aβ between the two groups. Conclusion NSE, S100β and β-amyoid peptide levels in serum significantly increase after operation. NSE and S100β of serum in group POCD are more.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第10期979-982,共4页
Journal of Clinical Anesthesiology
