8-异前列腺素和丙二醛与老年患者术后认知功能障碍的探讨

Study on the Cognitive Dysfunction in the Elderly Patients with 8-Isoprostane and Malondialdehyde

目的:探讨尿排泄率8-异前列腺素(U8-iso PG)与肌酐(Cr)的比值(U8-iso PG:Cr)和丙二醛(UMDA)与Cr的比值(UMDA:Cr)与老年患者术后认知功能障碍(POCD)的相关性。方法:72例>65岁老年患者分别于手术前,手术后1周接受认知测试调查,通过"Z"评分确定认知功能障碍组(POCD组,21例)和非POCD组(对照组,51例)。分别于术前、术后1、2和7天收集晨尿。U8-isoPG采用酶联免疫吸附法(ELISA法),UMDA采用测定分光光度检测,并检测Cr浓度。结果:⑴手术后第7天POCD组的U8-iso PG:Cr高于对照组,与手术前相比升高的值也高于对照组(P<0.05)。⑵两组患者UMDA:Cr术后第1,2天较术前明显升高(P<0.05),术后第7天较术前差异没有统计学意义(P>0.05);两组间比较差异没有统计学意义(P>0.05)。结论:尿U8-isoPG是一个有价值的检测脂质过氧化标记物,可能与老年患者术后POCD有关;尿丙二醛没有参与早期POCD的发病机制。

Objective： To investigate the urinary excretion of 8-iso-prostaglandin 8-（U8-iso PG） and creatinine（Cr） ratio（U8-iso PG：Cr） and malondialdehyde（UMDA） and the ratio of Cr（UMDA：Cr） in elderly patients with postoperative cognitive dysfunction（POCD） correlation. Methods： 72 cases of elderly patients over 65 years were surveyed before surgery, cognitive tests 1 weeks after the operation, through the ＂Z＂ score to determine the cognitive dysfunction group（group POCD, 21 cases） and non POCD group（control group, 51 cases）. Morning urine was collected at 1, 2, and 7 days after surgery, respectively. U8-iso PG enzyme linked immunosorbent assay（ELISA method）, UMDA using spectrophotometric detection, and detection of Cr concentration. Results： ⑴7 days after surgery in POCD group U8-iso PG：Cr was higher than the control group, compared with preoperative elevated value is higher than that of the control group（P〈0.05）. ⑵7 days after surgery, two groups of patients after UMDA：Cr was significantly higher than that before operation（P〈0.05）, 7 day after operation compared with the preoperative difference was not statistically significant（P〉0.05）; the difference between the two groups was not statistically significant（P〉0.05）. Conclusion： Urinary U8-iso PG is a valuable marker of lipid peroxidation, which may be related to postoperative POCD in elderly patients, and urinary MDA is not involved in the pathogenesis of POCD in the early stage.