雌激素与老年患者全麻术后认知功能障碍关系的研究

Study on the relationship between the estrogen and the postoperative cognitive dysfunction in elderly people under general anesthesia

目的探讨雌激素与老年患者全麻术后认知功能障碍的关系。方法用简易精神状态量表（MMSE）对80例年龄在64～70岁的患者进行术前、术后3天和7天认知功能评价。按MMSE得分将患者分为认知功能正常组和认知功能障碍组，同时采用放射免疫学的方法，测定术前、术后3天及术后7天各样本血清雌二醇的水平，比较同性别中认知功能正常组和认知功能障碍组雌二醇的水平。结果同性别中术后3天和7天认知功能障碍组手术前后雌二醇的水平较认知功能正常组低（P〈0．01）。结论老年患者全麻术后认知功能障碍的发生可能与雌激素水平降低有关。

Objective To explore the relationship between the estrogen and the postoperative cognitive dysfunction in elderly people under general anesthesia. Methods The cognitive function of 80 patients aged 64-70 years were tested with mini-mental state examination（MMSE） before operation and on the 3rd and 7th postoperative day.On the basis of MMSE scores ,the samples were divided into two groups ,the normal cognitive group and the impaired cognitive group ,the following serum estradiol levels of the patients before operation and on the 3rd and 7th postoperative day were measured with radioimmunoassay ,and the changes of the estradiol levels in the normal cognitive groups compared with those in the impaired cognitive groups in the same sex. Results In the same sex ,the levels of serum estradiol in the impaired cognitive group were significantly lower than those in the normal cognitive groups before operation and on the 3rd or 7th postoperative day（P〈0.01 ）. Conclusion The postoperative cognitive dysfunction in elderly people under general anesthesia is closely associated with the decline of serum estrogen levels.