CRP与心脏手术女性患者术后认知功能的关系

Relationship between C-reactive protein and postoperative cognitive function of female patients who undergoing CPB （cardiopulmonary bypass ） cardiac surgery

目的观察C-反应蛋白（CRP）与心脏手术女性患者术后认知功能的相关性。方法2012年1月至2013年5月本院收治的60例行体外循环（CPB）心脏手术女性患者，均采用全身麻醉，麻醉诱导前及术后6d分别抽血测定CRP的浓度。术前1d、术后7d、术后1个月访视患者，用成人韦氏2＋1（WAIS—RC）、数字广度进行神经心理学测试。结果（1）术后7d认知障碍（POCD）的发生率为50％，术后1个月POCD的发生率为25％；（2）术前1d、术后6dCRP浓度与术后7d、术后1个月认知功能得分呈负相关（P〈0．05）；（3）术后6dCRP与数字广度呈负相关（P〈0．05）。结论CPB后有较高的POCD发生率；监测血清CRP水平的变化可能对心脏手术后认知障碍筛查具有重要意义。

Objective To investigate the relationship between C-reactive protein （CRP） and post operative cognitive function of female patients underwent cardiopulmonary bypass （ CPB ） cardiac surgery. Methods Sixty female patients were scheduled for CPB surgery from January 2012 to May 2013, aged form 35 to 60 years, mean aged （47.5 ± 12. 5） years, and in state of ASAⅡ-Ⅲ. All patients had general anesthesia and CPB cardiac surgery. Blood samples were taken from peripheral vein before induction and 6 days after surgery. The neuropsychology assessment was measured with Weehsler Adult Intelligence Scale RC 2 ＋ 1 （WAIS-RC） and digital span the first day preoperative, the 7th day, and the first month postoperative. The postoperative cognitive dysfunction （POCD） was judged with Newman style. Results （1） The rate of POCD of the 7th day and first month postoperatively was 50% and 25% , respectively. （2） The Pearson＇s correlation showed negative correlation between CRP preoperative at the 6th day and the 7th day, and the first month postoperative WAIS-RC score（ P 〈 0.05 ）. （3） The Pearson＇s figure showed negative correlation between CRP at the 6th day postoperative with digital span （ P 〈 0. 05 ）. Conclusions The ratio of POCD after CPB surgery was higher. It is instructively significant to monitor the variations of concentration of serum CRP for the selection of cognitive impairment in patients with cardiac-pulmonary bypass surgery.