本文選題：丙泊酚 + 腦源性神經(jīng)營養(yǎng)因子　； 參考：《實用藥物與臨床》2016年02期

【摘要】：目的探討丙泊酚全憑靜脈麻醉對前列腺電切術(shù)后老年患者血清腦源性神經(jīng)營養(yǎng)因子(Brainderived neurotrophic factor,BDNF)、S100B蛋白及認知功能的影響。方法選擇擇期行前列腺電切術(shù)的老年患者60例,年齡65~86歲,隨機分為丙泊酚組(試驗組)和異氟醚組(對照組),每組30例。分別于術(shù)前及術(shù)后6、24、72 h檢測血清BDNF、S100B蛋白,并采用蒙特利爾認知評估量表(Mo CA)評價認知功能。結(jié)果術(shù)前兩組患者血清BDNF、S100B蛋白水平及Mo CA評分差異無統(tǒng)計學(xué)意義(P0.05);術(shù)后6、24 h兩組血清BDNF水平較麻醉前明顯下降(P0.05或P0.01),且丙泊酚組下降幅度低于異氟醚組(P0.05);兩組術(shù)后6、24 h血清S100B蛋白較麻醉前明顯上升(P0.05或P0.01),且試驗組上升幅度低于對照組(P0.05)。兩組術(shù)后72 h血清BDNF、S100B蛋白均恢復(fù)到麻醉前水平(P0.05)。兩組術(shù)后6、24 h Mo CA評分均較麻醉前明顯下降(P0.05或P0.01),且試驗組下降幅度低于對照組(P0.05)。兩組術(shù)后72 h Mo CA評分均恢復(fù)到麻醉前水平(P0.05)。試驗組麻醉術(shù)后認知障礙的發(fā)生率均低于對照組(P0.05)。相關(guān)性分析顯示,術(shù)后Mo CA評分與血清BDNF水平呈正相關(guān)(r=0.371,P0.01),而與S100B蛋白水平呈負相關(guān)(r=-0.472,P0.01)。結(jié)論兩組麻醉方式對老年患者術(shù)后早期的認知功能均有影響,認知功能下降可能與BDNF下降、S100B蛋白升高有關(guān),但丙泊酚對老年患者影響更小,其作用與降低患者血清S100B蛋白水平密切相關(guān)。
[Abstract]:Objective to investigate the effect of propofol total intravenous anesthesia on serum brainderived neurotrophic factor brain-derived neurotrophic factor (BDNF) S100B protein and cognitive function in elderly patients after prostatectomy. Methods Sixty elderly patients aged 65 to 86 were randomly divided into propofol group (experimental group) and isoflurane group (control group, 30 cases in each group). The serum BDNF S100B protein was measured before and 6 days after the operation, and the cognitive function was evaluated by the Montreal Cognitive Assessment scale (MOCA). Results there was no significant difference in serum BDNF S100B protein level and Mo CA score between the two groups before operation (P 0.05), and the serum BDNF level in the two groups was significantly lower than that before anesthesia (P0.05 or P0.01) at 6 h after operation, and the decrease in propofol group was lower than that in isoflurane group (P 0.05), while that in the propofol group was lower than that in the isoflurane group (P 0.05). The serum S100B protein was significantly higher than that before anesthesia (P 0.05 or P 0.01) at 6 h after anesthesia, and the increase in the test group was lower than that in the control group (P 0.05). The serum BDNF S100B protein returned to the pre-anesthesia level at 72 h after anesthesia in both groups. The scores of 24 h Mo CA after operation in both groups were significantly lower than those before anesthesia (P 0.05 or P 0.01), and the decrease in the test group was lower than that in the control group (P 0.05). The 72 h Mo CA score of both groups recovered to the pre-anesthesia level (P 0.05). The incidence of cognitive impairment after anesthesia in the trial group was lower than that in the control group (P 0.05). The correlation analysis showed that there was a positive correlation between Mo CA score and serum BDNF level, but a negative correlation between Mo CA score and S100B protein level. Conclusion the anaesthesia style of the two groups has an effect on the early cognitive function of the elderly patients. The decrease of cognitive function may be related to the increase of S100B protein in BDNF, but propofol has less effect on the elderly patients. Its effect is closely related to the decrease of serum S100B protein level.
【作者單位】： 廣東潮州188醫(yī)院麻醉科;
【分類號】：R614
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本文編號：1928843