本文關鍵詞：老年患者術后認知障礙的神經(jīng)元電生理功能障礙機制　出處：《中國老年學雜志》2017年03期 　論文類型：期刊論文

  更多相關文章： 電生理 神經(jīng)元 線粒體 認知功能障礙

【摘要】：目的 從神經(jīng)元電生理功能障礙探討老年患者術后認知功能障礙(POCD)的機制。方法 40例因急性腦血管病住院的老年患者作為發(fā)病組,另選同期40例老年全身麻醉術后患者作為對照組。入院后均給予常規(guī)治療。治療前、治療開始后2、7、14 d分別利用熒光探針經(jīng)過JC-1熒光染色對白細胞內(nèi)線粒體進行染色標記后進行流式細胞儀測定線粒體膜電位。記錄發(fā)病組治療前及治療后14 d及對照組相對應時間點的事件相關電位P300及N200。結(jié)果 與對照組相比,發(fā)病組治療前、治療后2、7 d線粒體膜電位下降(P0.05);治療后14 d時兩組比值基本相同(P0.05)。發(fā)病組P300和N200潛伏期治療前比對照組明顯延長(P0.05),治療后14 d發(fā)病組P300和N200的潛伏期比治療前明顯縮短(P0.05);發(fā)病組P300和N200波幅在治療前比對照組明顯降低(P0.05),治療后14 d發(fā)病組P300和N200的波幅比治療前明顯升高(P0.05)。結(jié)論 麻醉手術的強應激刺激導致神經(jīng)元線粒體膜氧化應激可能導致神經(jīng)元損害;事件相關電位P300、N200可作為早期反映POCD的神經(jīng)電生理指標。
[Abstract]:Objective to explore the mechanism of post operative cognitive dysfunction (POCD) in elderly patients with neuronal electrophysiological dysfunction. Methods 40 elderly patients with acute cerebrovascular disease were selected as the onset group. Another 40 elderly patients after general anesthesia were selected as the control group. After admission, all patients were given routine treatment. Before treatment, 2 minutes after treatment. On the 14th day, mitochondrial membrane potential in leukocytes was detected by flow cytometry after labeling with JC-1 fluorescence staining with fluorescent probe. 14 days after treatment and 14 days after treatment, the mitochondrial membrane potential was recorded in the onset group. D and the corresponding time points of the control group P300 and N200.The results were compared with those of the control group. Before and 2 days after treatment, the mitochondrial membrane potential decreased in the onset group (P 0.05). At the 14th day after treatment, the ratio of P300 and N200 was almost the same in the two groups. The latency of P300 and N200 in the disease group was significantly longer than that in the control group before treatment (P 0.05). The latencies of P300 and N200 in the onset group were significantly shorter than those before treatment on the 14th day after treatment. The amplitude of P300 and N200 was significantly lower than that of control group before treatment (P 0.05). The amplitudes of P300 and N200 in the onset group were significantly higher than those before treatment on the 14th day after treatment (P 0.05). Conclusion oxidative stress of mitochondria membrane may result in neuronal damage due to strong stress stimulation during anaesthesia. Event-related potential P 300 N 200 can be used as an early neurophysiological index to reflect POCD.
【作者單位】： 哈勵遜國際和平醫(yī)院神經(jīng)內(nèi)一科;
【分類號】：R741.02
【正文快照】： 術后認知功能障礙(POCD)是指術前無認知功能障礙的病人在全身麻醉術后出現(xiàn)的中樞神經(jīng)系統(tǒng)紊亂,多在經(jīng)歷重大手術或急診手術后發(fā)生,最常見于老年患者,多數(shù)呈現(xiàn)可逆性和波動性,但臨床上仍可見部分患者遺留永久性POCD〔1,2〕。研究顯示,老年患者經(jīng)歷心臟手術后POCD發(fā)生率可高達10

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