S-100β蛋白、IL-1β、IL-6和α-TNF的表达在全膝置换术后认知功能障碍的相关性研究

Relativity Research of Expression of S-100β Protein,IL-1β,IL-6 and α-TNF to Recognition after Total Knee Arthroplasty

[目的]探讨老年患者术后认知功能障碍(Postoperative cognitive dysfunction,POCD)与血清S-100β蛋白、IL-1β、IL-6和α-TNF表达的关系。[方法]选择全麻下行单侧全膝置换术老年患者45例,术前1d、术后1d采用简易智能量表(MMSE)评价患者认知功能,以术后1d评分较术前1d降低2分或以上者归为POCD组(19例),下降少于1分或上升者归为非POCD组(26例)。并于诱导前、术毕和术后1d采血检测S-100β蛋白、IL-1β、IL-6和α-TNF。[结果]与麻醉诱导前相比,术毕时两组患者血清S-100β蛋白、IL-1β、IL-6和α-TNF均明显升高(P<0.05),但两组间无明显差异(P>0.05)。术后1d仅POCD组IL-6较术前明显升高(P<0.05),且与非POCD组相比也明显升高(P<0.05)。[结论]全麻下行单侧全膝置换老年患者发生POCD与术后血清中IL-6表达关系较密切。

[Objective] To explore the relationship between postoperative cognitive dysfunction（POCD） and expression of S-100β protein,IL-1β,IL-6 and α-TNF.[Method] Select 45 cases of senile total knee arthroplasty,assess their cognitive function with MMSE 1d before and after operation,take those with score 2 or above lower than before operation as POCD group（n=19）,lower than score 1 or rising as non-POCD group（n=26）.Take blood before induction at the end of the operation and 1d after operation for testing S-100β protein,IL-1β,IL-6 and α-TNF.[Result] Compared to before anesthesia induction,at the end of operation,both groups＇ serum S-100β protein,IL-1β,IL-6 and α-TNF rose markedly,there＇s no marked difference between them.1 d after operation,the IL-6 of POCD group rose much more than before operation,as well as compared to non-POCD group.[Conclusion] Under general anesthesia,total knee arthroplasty senile patients＇ POCD was closely related with serum IL-6 expression.