结直肠手术后认知功能障碍患者血清细胞因子的差异表达

发布时间：2019-06-18 23:01

【摘要】：目的应用高通量细胞因子抗体芯片筛查结直肠手术后认知功能障碍(POCD)患者血清差异表达的细胞因子并进行验证。方法 80例择期行结直肠手术患者,根据认知功能测试量表判定POCD,于手术前1 d、术后4 h取血分离血清,高通量细胞因子芯片筛查120个血清细胞因子,差异5倍以上因子经ELISA验证。结果 77例患者完成认知量表和血样采集,术后第7天,19例发生POCD。POCD患者在年龄、麻醉风险ASA分级、糖尿病发病率、受教育程度与非POCD患者有明显差异。高通量筛查出的5倍以上差异表达血清细胞因子9个,经ELISA验证结果显示:POCD患者术前白细胞介素17(IL-17)、Fas、巨噬细胞炎性蛋白3α(MIP-3α)水平明显高于非POCD患者,瘦素(leptin)明显低于非POCD患者;术后4 h血清IL-6、IL-11、IL-17、甲基受体趋化蛋白3(MCP3)、骨髓造血祖细胞抑制因子(MPIF-1)、MIP-3α明显高于非POCD患者,脑源性神经营养因子(BDNF)明显低于非POCD患者。POCD患者术后4 h的IL-6、IL-17、MCP3、MPIF-1明显高于术前;非POCD患者术后4 h IL-6、IL-17明显高于术前,Fas、BDNF明显低于术前。结论结直肠手术POCD的发生伴随的血清细胞因子IL-6、IL-11、IL-17、Fas、MPIF-1、MIP-3α、MCP3、leptin、BDNF的差异表达。
[Abstract]:Objective to screen and verify the differentially expressed cytokines in serum of (POCD) patients with cognitive impairment after colorectal surgery by high throughput cytokine antibody chip. Methods 80 patients undergoing elective colorectal surgery were enrolled in this study. According to the cognitive function test scale, serum samples were isolated from POCD, 1 day before operation and 4 hours after operation. 120 serum cytokines were screened by high throughput cytokine microarray. The difference was more than 5 times as much as that by ELISA. Results 77 patients completed cognitive scale and blood sample collection. On the 7th day after operation, 19 patients with POCD.POCD had significant differences in age, ASA grade of anaesthesia risk, incidence of diabetes mellitus and education level compared with non-POCD patients. Nine serum cytokines were differentially expressed by high throughput screening. The results of ELISA showed that the level of IL-17), Fas, macrophage inflammatory protein 3 伪 (MIP-3 伪) in POCD patients was significantly higher than that in non POCD patients, and leptin (leptin) was significantly lower than that in non POCD patients. Serum IL-6,IL-11,IL-17, methyl receptor chemotactic protein 3 (MCP3), bone marrow hematopoietic progenitor cell inhibitory factor (MPIF-1) and MIP-3 伪 were significantly higher than those in non-POCD patients at 4 h after operation, and brain-derived neurotrophic factor (BDNF) was significantly lower than that in non-POCD patients. IL-6,IL-17,MCP3,MPIF-1 in POCD patients at 4 h after operation was significantly higher than that before operation. The IL-6,IL-17 and Fas,BDNF of non-POCD patients at 4 h after operation were significantly higher than those before operation, and Fas,BDNF were significantly lower than those before operation. Conclusion the differential expression of serum cytokines IL-6,IL-11,IL-17,Fas,MPIF-1,MIP-3 伪 and MCP3,leptin,BDNF associated with the occurrence of POCD in colorectal surgery.
【作者单位】：南京医科大学公共卫生学院分子毒理实验室;南京医科大学第一附属医院麻醉科;南京医科大学附属南京医院麻醉科;
【基金】：国家自然科学基金(81270429)
【分类号】：R735.34

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