胃癌患者围术期血浆Aβ水平变化及与术后认知功能障碍的关系

Changes of plasma levels of β-amyloid protein and its relationship with postoperative cognitive dysfunction in stomach cancer patients

目的检测胃癌患者围术期血浆β-淀粉样蛋白(Aβ)水平变化,并探讨其与术后认知功能障碍(POCD)的关系。方法研究对象为50例择期行七氟醚全麻下胃癌根治术患者,于术前1 d和术后7 d分别进行神经心理测验,统计POCD发生率;术前1 d(T0)及手术开始2 h(T1)、4 h(T2)、24 h(T3)、48 h(T4)、7 d(T5)采用ELISA法测定血浆Aβ水平。结果 46例患者完成神经心理测试,9例(19.6%)发生POCD(POCD组)、余37例未发生POCD(非POCD组)。POCD组术后T1～T5血浆Aβ水平较T0明显升高,尤以T3、T4更为显著(P<0.05、0.01);非POCD组T1～T5血浆Aβ浓度较T0有所增加(P>0.05),但各时间点无显著差异。结论老年胃癌患者围术期血浆Aβ水平升高并与POCD发生有关。

Objective To observe the peioperative change of plasma beta-amyloid protein （Aβ） in stomach cancer patients, and explore its correlation with postoperative congnitive dysfunction（POCD）. Methods Fifty patients scheduled for resection of stomach cancer under sevoflurane anesthesia were enrolled in the study, the patients＂ cognitive functions were assessed using a neuropsychological tests, on the day before the surgery and then again 1 week after the surgery, the incidence rate of POCD was counted. Venous blood samples were taken for the measurement of plasma Aβ before operation （TO）, at 2 h（T1）, 4 h（T2） during operation, 24 h（T3） and 48 h（T4）, the 7th day（TS）, post operation. Results Forty-six patients completed neuropsychological testing, 9 cases （ 19.6% ） occurred POCD （POCD group） and 37 cases not （non POCD group）. The plasma Aβ levels in POCD group at T1 - T5 were significantly higher then that at TO, especially at T3, T4 （P 〈 0.05, 0.01 ） ; In the non POCD group, the plasma Aβ levels at T1 - T5 were also higher than that at T0, but no significant differences was found at each time point （P 〉 0.05 ）. Conclusions The perioperative plasma Aβ levels of stomach cancer patients increases, and which is related with the occurrence of POCD.