丙泊酚静脉麻醉对前列腺电切术后患者血清BDNF、S100B蛋白及认知功能的影响

发布时间：2018-05-24 11:13

  本文选题：丙泊酚 + 脑源性神经营养因子　； 参考：《实用药物与临床》2016年02期

【摘要】：目的探讨丙泊酚全凭静脉麻醉对前列腺电切术后老年患者血清脑源性神经营养因子(Brainderived neurotrophic factor,BDNF)、S100B蛋白及认知功能的影响。方法选择择期行前列腺电切术的老年患者60例,年龄65~86岁,随机分为丙泊酚组(试验组)和异氟醚组(对照组),每组30例。分别于术前及术后6、24、72 h检测血清BDNF、S100B蛋白,并采用蒙特利尔认知评估量表(Mo CA)评价认知功能。结果术前两组患者血清BDNF、S100B蛋白水平及Mo CA评分差异无统计学意义(P0.05);术后6、24 h两组血清BDNF水平较麻醉前明显下降(P0.05或P0.01),且丙泊酚组下降幅度低于异氟醚组(P0.05);两组术后6、24 h血清S100B蛋白较麻醉前明显上升(P0.05或P0.01),且试验组上升幅度低于对照组(P0.05)。两组术后72 h血清BDNF、S100B蛋白均恢复到麻醉前水平(P0.05)。两组术后6、24 h Mo CA评分均较麻醉前明显下降(P0.05或P0.01),且试验组下降幅度低于对照组(P0.05)。两组术后72 h Mo CA评分均恢复到麻醉前水平(P0.05)。试验组麻醉术后认知障碍的发生率均低于对照组(P0.05)。相关性分析显示,术后Mo CA评分与血清BDNF水平呈正相关(r=0.371,P0.01),而与S100B蛋白水平呈负相关(r=-0.472,P0.01)。结论两组麻醉方式对老年患者术后早期的认知功能均有影响,认知功能下降可能与BDNF下降、S100B蛋白升高有关,但丙泊酚对老年患者影响更小,其作用与降低患者血清S100B蛋白水平密切相关。
[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.
【作者单位】： 广东潮州188医院麻醉科;
【分类号】：R614
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本文编号：1928843