静脉和吸入麻醉后认知功能障碍与BACE1基因多态性的关系

An association between BACE1 gene polymorphism and postoperative cognitive dysfunction after intravenous anesthesia and inhalation anesthesia

目的比较和分析静脉麻醉和吸入麻醉后出现的认知功能障碍与β分泌酶基因多态性的关系。方法 1 000例受试者被随机分配在静脉麻醉组和吸入麻醉组,分别接受全凭静脉麻醉和吸入麻醉。用简易精神量表分析患者术后认知功能,评分小于25分被诊断为认知功能障碍。从受试者全血中提取DNA,用PCR方法扩增β-分泌酶1、β-分泌酶2(BACE1、BACE2)基因,记录两种基因BACE1和BACE2限制性酶切片段的个数。结果在静脉麻醉组中,评分的降低与β分泌酶基因单核苷酸多态性没有相关性,而在吸入麻醉组中评分的降低与β分泌酶基因1单核苷酸多态性的相关性有统计学意义。结论携带β分泌酶1基因单核苷酸多态性的患者应慎用吸入麻醉。

Objective To explore the relationship between the BACE gene polymorphism and postoperative cognitive dysfunction after general anesthesia.Methods The subjects were equally and randomly divided into intravenous anesthesia group and inhalation anesthesia group.Cognitive function was assessed daily using mini-mental state examination（MMSE）.Patients with MMSE score less than 25 were diagnosed with cognitive dysfunction.Genomic DNA from whole blood was extracted.The BACE1 and BACE2 genes were amplified by PCR.The numbers of restriction fragment lengths of BACE1 and BACE2 gene were recorded.Results The decrease in MMSE score was closely correlated with BACE1 allele in inhalation anesthesia group while such a correlation was not observed in intravenous anesthesia group.Conclusion There is a strong association between the BACE1 and postoperative cognitive dysfunction in elderly patients undergoing inhalation anesthetics,suggesting that the elderly patients with BACE1 allele should be undergone inhalation anesthetics cautiously.