右美托咪啶对阻塞性睡眠呼吸暂停患者术后认知功能的影响

发布时间：2018-02-22 10:48

本文关键词： 右美托咪啶 Sβ蛋白神经元特异性烯醇化酶 OSA 认知功能　出处：《实用医学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的:探讨右美托咪啶对阻塞性睡眠呼吸暂停(OSA)患者术后认知功能的影响。方法:择期拟行膝关节置换术的OSA患者50例,随机分为右美托咪啶组(DEX组,n=25)和对照组(C组,n=25),分别在麻醉前和术中给予右美托咪啶和等量生理盐水持续泵注,两组患者的麻醉诱导和维持方法相同。于围术期不同时间点评估患者认知功能障碍发生情况;分别于麻醉前(T1)、术后3 h(T2)、6 h(T3)、24 h(T4)、48 h(T5)5个时间点测定静脉血中S100β、神经元特异性烯醇化酶(NSE)水平。结果:术后第1天DEX组的MMSE评分高于对照组,差异有统计学意义(P0.05);DEX组MMSE评分早于对照组恢复至术前水平。T2、T3、T4时刻两组血清S100β蛋白、NSE水平均较T1显著升高,T3时刻达到峰值,但DEX组升高幅度低于对照组,差异有统计学意义(P0.05)。结论:围术期应用右美托咪啶可以降低OSA患者术后认知功能障碍的发生率,其机制可能与神经保护有关。
[Abstract]:Objective: to investigate the effect of dexmetidine on cognitive function in patients with obstructive sleep apnea (OSA) after operation. The rats were randomly divided into two groups: dexmetidine group (DEX group) and control group (group C). Before and during anesthesia, dexmetomidine and the same amount of normal saline were continuously injected by pump before and during anesthesia, respectively. The induction and maintenance of anesthesia were the same between the two groups. The incidence of cognitive dysfunction was evaluated at different time points in perioperative period. The levels of S100 尾 and neuron-specific enolase (NSE) in venous blood were measured at 5 time points before anesthesia and 6 h after operation. Results: the MMSE score of DEX group was higher than that of control group on the first day after operation. The difference was statistically significant (P 0.05). The MMSE score of the DEX group was earlier than that of the control group. The serum S100 尾 protein level of the two groups was significantly higher than that of T1 and reached the peak at T3, but the increase of DEX group was lower than that of the control group. Conclusion: the perioperative use of dexmetidine can reduce the incidence of cognitive dysfunction in patients with OSA, and its mechanism may be related to neuroprotection.
【作者单位】：吉林大学第一医院;吉林大学第四医院;
【基金】：吉林省自然科学基金(编号:201015121)
【分类号】：R614

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