川芎嗪对高龄骨科手术患者血清S100β蛋白及神经元特异性烯醇化酶的影响

Effects of Ligustrazine on Serum S100β Protein and Neuron-Specific Enolase in Elderly Patients Undergoing Orthopedics Operations

目的观察川芎嗪对高龄骨科手术患者血清S100β蛋白和神经元特异性烯醇化酶（NSE）的影响。方法选择美国麻醉医师协会（American Society of Anesthesiologists,ASA）Ⅰ或Ⅱ级、年龄65~80岁择期全髋关节置换手术患者60例,随机分为试验组（川芎嗪组）和对照组（生理盐水组）。麻醉诱导气管插管后行右颈内静脉穿刺向头侧置管,使导管尖端位于颈内静脉球部。试验组于手术开始前经中心静脉内滴注川芎嗪注射液2mg/kg（每分钟40滴）;对照组以等量生理盐水代替。两组患者术中和术后用药保持一致。术前（T0）、术后24h（T1）、72h（T2）、168h（第7天,T3）分别采集颈内静脉球部血5mL,离心后取血清,采用酶联免疫分析法测定S100β蛋白和NSE浓度。T0、T1、T2、T3由同一医师分别进行简易智能状态检查（MMSE）评分。结果两组患者T0时MMSE评分、S100β蛋白和NSE浓度比较,差异无统计学意义（P〉0.05）;与T0时比较,两组患者T1、T2、T3时S100β蛋白和NSE浓度均升高,MMSE评分均下降,除对照组T3时外,试验组与对照组S100β蛋白和NSE浓度比较,差异亦有统计学意义（P〈0.05）。结论术前静脉注射川芎嗪可以改变高龄骨科手术患者术后血清S100β蛋白和神经元特异性烯醇化酶的浓度。

Objective To observe effects of Ligustrazine on serum S100βprotein and neuron-specific enolase（NSE）in elderly patients undergoing orthopedics operations.Methods Totally 60 patients undergoing selective total hip replacement,65-80 years old,who were in line with American Society of Anesthesiologists（ASA）gradeⅠ orⅡ,were randomly assigned to the Ligustrazine group（Group L）and the normal saline control group（Group S）.The right internal jugular vein catheters were placed cephalad and ensured theirs tips in jugular venous bulbs after anesthesia induction and tracheal intubation.Patients in Group L received 2mg/kg Ligustrazine Injection（40drops within one minute）and those in Group S received equal volume of normal saline via central veins before operations.Other medicines were the same for all patients during and after operation.Five millimeter blood sample was collected from internal jugular venous bulbs before operation（T0）,24h（T1）,72h（T2）,168h（7th day,T3）after operation.Serum was collected after centrifuge.S100βprotein and NSE concentration were analyzed using ELISA.Mini-mental state examinations（MMSE）were scored by the same doctor at T0,T1,T2,and T3,respectively.Results There was nostatistical difference in MMSE scores,serum S100βprotein,or NSE at T0（P〉0.05）.Compared with T0,S100βprotein and NSE concentration increased and MMSE scores decreased at T1,T2,and T3 in the two groups.All indices except S100βprotein and NSE at T3 were statistically different between Group L and Group S（P〈0.05）.Conclusion Serum S100βprotein and NSE could be changed by pre-operation injecting Ligustrazine at certain dose in elderly patients undergoing orthopedics operations.