摘要
目的:观察异氟烷全麻围术期老年患者血清淀粉样蛋白-β(1-40)[Aβ(1-40)]和锌水平的变化。方法:将2007年6月至2008年3月拟开腹手术患者40例纳入研究。依年龄将患者分为2组:老年组(20例)与非老年组(20例)。老年组中男12例,女8例,平均年龄(72.39±4.11)岁;非老年组中男11例,女9例,平均年龄(48.15±5.62)岁。患者入手术室后行麻醉诱导和气管插管,并吸入异氟烷1～1.5最低肺泡浓度(MAC)维持麻醉。麻醉前及麻醉后2、4、24 h采集患者肘静脉血3 ml,用酶联免疫吸附试验(ELISA)和生化法分别测定血清Aβ(1-40)和锌水平。结果:老年组与非老年组患者麻醉前血清Aβ(1-40)水平分别为(5.03±1.96)μg/ml和(3.92±0.46)μg/ml,差异有统计学意义(P<0.05)。老年组与非老年组患者麻醉后2、4、24 h Aβ(1-40)水平均增高,分别为(7.95±1.66)μg/ml、(7.63±1.51)μg/ml、(6.94±1.43)μg/ml与(5.15±0.72)μg/ml、(6.34±0.99)μg/ml、(4.81±0.81)μg/ml;2组麻醉前后以及麻醉后2组间各时间点血清Aβ(1-40)水平比较差异均有统计学意义(均P<0.05)。老年组与非老年组患者麻醉前血清锌水平分别为(14.36±1.38)μg/ml和(14.64±1.75)μg/ml。老年组与非老年组患者麻醉后2、4、24 h血清锌水平分别为(12.71±1.36)μg/ml、(10.64±1.83)μg/ml、(8.07±1.61)μg/ml和(13.10±1.68)μg/ml、(11.16±1.74)μg/ml、(9.40±1.99)μg/ml;2组麻醉前后及麻醉后24 h 2组间血清锌水平比较差异均有统计学意义(均P<0.05)。结论:异氟烷全麻围手术期老年患者血清淀粉样蛋白-β(1-40)水平明显升高,血清锌降低。
Objective： To observe the changes in serum amyloid-beta （1-40） [ Aβ （1-40）] and zinc levels in elderly patients receiving general anesthesia with isoflurane during perioperative period. Methods： From June 2007 to March 2008, forty patients planning to undergo laparatomy were enrolled in the study. The patients were divided into following two groups based on age： the elderly patient group （20 cases） and the non-elderly patient group （20 cases）. The elderly patient group comprised 12 men and 8 women with average age of （ 72.39 ± 4.11 ） years. The non-elderly patient group comprised 11 men and 9 women with average age of （48.15 ± 5. 62） years. After transferring to the operation room, the patients in both groups received anesthesia induction and endotracheal intubation, followed by isoflurane 1 to 1.5 minimal alveolar concentration （MAC） for anesthesia maintenance. Three ml of blood was taken from the patients＇ cubital vein before anesthesia and 2, 4, and 24 hours after anesthesia, respectively. Serum Aβ （1-40） and zinc levels were measured with ELISA and biochemical analysis, respectively. Results： Average serum Aβ（1-40） level before anesthesia in the elderly patient and non-elderly patient groups were （ 5.03 ± 1.96 ） μg/ml and （ 3.92 ± 0.46 ） μg/ml, respectively. The difference was statistically significant （ P 〈 0.05 ）. Average serum Aβ （ 1-40 ） levels 2,4, and 24 hours after anesthesia in the elderly patient and non-elderly patient groups were increased： （7.95 ± 1.66） μg/ml, （7.63 ± 1.51 ） μg/ml, （6.94 ± 1.43） μg/ml and （5.15 ±0.72） μg/ml, （6.34 ±0.99） μg/ml, （4.81 ±0.81 ） μg/ml, respectively. The differences in Aβ（ 1- 40） level in both groups between before anesthesia and after anesthesia, as well as at different time points after anesthesia between the two groups, were statistically significant （ all P 〈 0.05 ）. Average serum zinc levels before anesthesia in the elderly patient and nonelderly patient groups were （ 14.36 ± 1.38 ） μg/ml and （ 14.64 ± 1.75 ） μg/ml, respectively. Serum zinc levels 2,4 and 24 hours after anesthesia in the elderly patient and non-elderly patient groups were （ 12.71 ± 1.36） μg/ml, （ 10.64 ± 1.83 ） μg/ml, （8.07 ± 1.61 ） μg/ml and （13.10±1.68） μg/ml, （11.16 ± 1.74） μg/ml, （9.40 ± 1.99） μg/ml, respectively. The differences in serum zinc levels in both groups between before anesthesia and after anesthesia, as well as 24 hours after anesthesia between the two groups, were statistically significant （all P 〈0.05 ）. Conclusion： Markedly increased serum amyloid-beta （1-40） levels and decreased serum zinc levels occur in elderly patients receiving general anesthesia with isoflurane during perioperative period.
出处
《药物不良反应杂志》
2009年第3期161-164,共4页
Adverse Drug Reactions Journal
基金
"首都医科大学基础临床科研合作"资助项目(2007JL11)
