老年患者术后认知障碍的神经元电生理功能障碍机制

发布时间：2018-01-18 04:31

本文关键词：老年患者术后认知障碍的神经元电生理功能障碍机制　出处：《中国老年学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的从神经元电生理功能障碍探讨老年患者术后认知功能障碍(POCD)的机制。方法 40例因急性脑血管病住院的老年患者作为发病组,另选同期40例老年全身麻醉术后患者作为对照组。入院后均给予常规治疗。治疗前、治疗开始后2、7、14 d分别利用荧光探针经过JC-1荧光染色对白细胞内线粒体进行染色标记后进行流式细胞仪测定线粒体膜电位。记录发病组治疗前及治疗后14 d及对照组相对应时间点的事件相关电位P300及N200。结果与对照组相比,发病组治疗前、治疗后2、7 d线粒体膜电位下降(P0.05);治疗后14 d时两组比值基本相同(P0.05)。发病组P300和N200潜伏期治疗前比对照组明显延长(P0.05),治疗后14 d发病组P300和N200的潜伏期比治疗前明显缩短(P0.05);发病组P300和N200波幅在治疗前比对照组明显降低(P0.05),治疗后14 d发病组P300和N200的波幅比治疗前明显升高(P0.05)。结论麻醉手术的强应激刺激导致神经元线粒体膜氧化应激可能导致神经元损害;事件相关电位P300、N200可作为早期反映POCD的神经电生理指标。
[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.
【作者单位】：哈励逊国际和平医院神经内一科;
【分类号】：R741.02
【正文快照】： 术后认知功能障碍(POCD)是指术前无认知功能障碍的病人在全身麻醉术后出现的中枢神经系统紊乱,多在经历重大手术或急诊手术后发生,最常见于老年患者,多数呈现可逆性和波动性,但临床上仍可见部分患者遗留永久性POCD〔1,2〕。研究显示,老年患者经历心脏手术后POCD发生率可高达10

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