老年患者血清NSE和S-100β蛋白水平变化与术后认知功能障碍的关系

Relationship between Postoperative Cognitive Dysfunction and Time Course of Serum Neuron-specific Enolase and S-100β Protein in Elderly Patients

目的观察老年患者手术前后血清神经元特异性烯醇化酶(NSE)及S-100β蛋白水平变化,探讨其与术后认知功能障碍(POCD)的关系。方法选择年龄≥60岁、择期手术患者120例,于术前、术毕、术后12、24、48 h测定血清NSE和S-100β蛋白水平;评估患者POCD发生情况;对POCD组和未发生认知功能障碍(NPCD)组手术前后血清NSE和S-100β蛋白水平变化进行比较。结果 120例患者血清NSE水平在术毕、术后12、24及48 h时均高于术前,血清S-100β蛋白水平在术毕时显著高于术前(P<0.05或P<0.01);POCD组术毕、术后12 h血清NSE和S-100β蛋白水平显著高于NPCD组(均P<0.01)。结论老年患者术后血清NSE及S-100β蛋白水平明显升高;老年患者术后血清NSE及S-100β蛋白水平升高与术后认知功能障碍发生有关。

Objective To investigate the time course of serum neuron-specific enolase（NSE） and S-100β protein in elderly patients undergoing operation,and to analyze their relationship with postoperative cognitive dysfunction（POCD）.Methods The levels of serum NSE and S-100β protein were detected in 120 patients（more than 60 years old） before and 12,24,48 hours after operation.POCD was evaluated and the time course of serum NSE and S-100β protein was compared between the patients with POCD and the patients with no POCD.Results In all 120 patients,serum NSE levels significantly increased at the end of operation and at 12,24,48 hours after operation,and S-100β protein levels obviously increased at the end of operation（P〈0.05 or P〈0.01）.Patients with POCD had significantly higher levels of NSE and S-100β protein than patients with no POCD at the end of operation and at 12 hours after operation（P〈0.01）.Conclusion Serum NSE and S-100β protein levels significantly increase after operation and are correlated with POCD in elderly patients.