老年全身麻醉患者认知功能障碍与血清细胞因子水平相关性研究

Correlation between cognitive dysfunction and serum cytokine levels in elderly patients with general anes thesia

目的分析老年全身麻醉后发生认知障碍患者的血清细胞因子水平,并分析其与认知功能障碍评分的相关性。方法选取2017年2月~2018年8月浙江省台州医院接受全麻手术的老年患者为研究对象,根据其是否发生认知功能障碍分为认知功能障碍组和未发生认知功能障碍组。观察两组患者血清细胞因子水平和认知功能评分,分析认知功能障碍患者细胞因子水平与认知功能的相关性。结果发生认知功能障碍的老年全身麻醉患者的S-100β、NSE水平分别为(0.45±0.11)μg/L、(12.32±2.15)μg/L,高于未发生认知功能障碍的患者,差异有统计学意义(t=-9.129、-11.762,P<0.01);发生认知功能障碍的老年全身麻醉患者定向力、瞬时记忆、注意力、计算力、短时记忆、语言能力、视空间觉得分低于未发生组患者,差异有统计学意义(t=-6.773、-12.201、-8.138、-12.218、-8.203、-10.717,P<0.01);认知功能障碍的老年全麻患者的S-100β、NSE水平与定向力、瞬时记忆、注意力计算力等呈负相关(P<0.05)。结论老年全身麻醉后发生认知障碍患者的血清细胞因子水平较高,且与认知功能评分负相关。

Objective To explore the correlation between cognitive impairment and serum cytokine levels in elderly patients with general anesthesia.Methods Elderly patients who underwent general anesthesia in our hospital from February 2017 to August 2018 were enrolled and were divided into cognitive dysfunction group and non-cognitive dysfunction group.Serum cytokine levels were measured and cognitive functions were scored,the correlation between cytokine levels and cognitive function in patients with cognitive dysfunction was analyzed.Results The serum levels of S-100βand NSE in elderly patients with cognitive dysfunction were 0.45±0.11μg/L and 12.32±2.15μg/L,which were significantly higher than those without cognitive dysfunction(t=-9.129,-11.762,P<0.01).The scores of orientation,transient memory and attention calculation in patients with cognitive dysfunction were significantly lower than those of patients without cognitive dysfunction(t=-6.773,-12.201,-8.138,-12.218,-8.203,-10.717,P<0.01).Serum levels of S-100βand NSE were negatively correlated with orientation,transient memory and attention calculation in patients with cognitive dysfunction(P<0.05).Conclusions The serum cytokine levels in elderly patients with cognitive impairment after general anesthesia are higher and negatively correlated with cognitive function scores.