摘要
目的探讨体外循环术后患者血清神经元特异烯醇化酶(neuron-specific enolase,NSE)和S100b蛋白水平与认知功能障碍(postoperative cognitive dysfunction,POCD)的关系。方法 64例接受体外循环心脏手术患者,术后出院前1d应用简易智能状态检查量表(mini-mental state examination,MMSE)评估患者认知功能,根据是否出现POCD分为POCD组和非POCD组,比较2组术前和术后6、24、48h血清NSE和S100b蛋白水平。结果体外循环术后19例出现POCD,45例未出现POCD。术前POCD组血清NSE[(7.18±1.61)μg/L]和S100b蛋白[(0.33±0.02)μg/L]水平与非POCD组[NSE(6.96±1.87)μg/L,S100b(0.31±0.01)μg/L]比较差异无统计学意义(P>0.05);术后6、24、48hPOCD组血清NSE[(24.12±4.53)、(20.37±3.29)、(18.96±4.12)μg/L)]和S100b蛋白[(1.39±0.14)、(1.21±0.11)、(1.13±0.13)μg/L]水平较术前和非POCD组[NSE(13.35±5.66)、(10.72±2.47)、(9.38±2.36)μg/L,S100b(0.67±0.07)、(0.62±0.06)、(0.52±0.09)μg/L]明显增高(P<0.05)。结论体外循环术后患者血清NSE和S100b蛋白水平与术后发生POCD有关,血清NSE和S100b蛋白可作为评价体外循环术后患者发生POCD的生物学标志物。
Objective To explore the relationship of serum neuron-specific enolase （NSE） and S100b protein levels with postoperative cognitive dysfunction （POCD） after cardiopulmonary bypass （CPB）. Methods Sixty-four patients with no POCD underwent CPB and evaluated the cognitive function by mini-mental state examination （MMSE） before discharge. All patients were divided into POCD group and non-POCD group. The levels of serum NSE and S100b protein were measured by using ELISA before operation, and 6, 24 and 48 h after operation. Results There were no significant differences in preoperative levels of serum NSE and S100b protein between POCD group （（7.18±1.61）, （0.33±0.02） μg/L） and non-POCDgroup （（6.96±1.87）, （0.31±0.01） μg/L） （P〉0.05）. The levels of serum NSE （（24. 12± 4.53）, （20.37±3.29）, （18.96±4.12） μg/L） and S100b protein （（1.39±0.14）, （1.21±0.11）, （1.13±0.13） μg/L） were significantly higher 6, 24 and 48 h after operation than those before operation in both two groups, and higher in POCD group than those in non-POCD group at the same time points after operation （NSE： （13.35±5. 66）, （10. 72± 2.47）, （9.38±2.36） μg/L; S100b： （0.67±0.07）, （0.62±0.06）, （0.52±0.09） μg/L） （P〈0.05）. Conclusion The levels of serum NSE and S100b protein are closely correlated with POCD after CPB, and can be regarded as the biomarkers for evaluating POCD.
出处
《中华实用诊断与治疗杂志》
2015年第9期903-905,共3页
Journal of Chinese Practical Diagnosis and Therapy
