老年全身麻醉患者血清S-100β蛋白、神经元特异性烯醇化酶及脑氧饱和度与认知功能障碍的相关性

Correlation between S-100β,NES,rSO_2 and POCD of elderly patients undergoing general anesthesia

目的探讨老年全身麻醉患者血清S-100β蛋白、神经元特异性烯醇化酶(NSE)及脑氧饱和度(rSO_2)与术后认知功能障碍(POCD)的相关性。方法选取该院127例选择全身麻醉进行手术的老年患者为研究对象,分为POCD组63例和对照组64例,分别检测2组患者术前、术中及术后血清S-100β蛋白、NES及rSO_2水平,并进行比对,分析3项检测指标与老年全身麻醉患者POCD的相关性。结果与对照组相比,POCD组患者血清S-100β和NES在手术开始时刻(T1)、手术进行1h(T2)、术毕(T3)和术后24h(T4)均明显升高,且明显高于麻醉诱导前(T0)(P<0.05);2组患者rSO_2水平在术中明显升高,并在术后降低,且POCD组术后rSO_2水平明显低于对照组及其T0时水平(P<0.05);血清S-100β蛋白和NES水平与老年全身麻醉患者MMSE评分呈负相关(r=-0.684、-0.729),而rSO_2则与患者简易智力精神状态量表评分呈正相关(r=0.891)。结论老年全身麻醉患者血清S-100β蛋白、NES和rSO_2均与POCD明显相关,可作为早期诊断POCD的参考依据。

Objective To explore the relationships between levels of S-100β protein,neuron-specific enolase （NSE）,cerebral oxygen saturation （rSO 2） and postoperative cognitive dysfunction （POCD） of elderly patients undergoing general anesthesia. Methods A total of 127 elderly patients undergoing general anesthesia were selected as study objects,and were divided into POCD group （63 cases） and control group （64 cases）.Serum S-100β protein,NES and rSO 2 levels were detected respectively at preoperative,intraoperative and postoperative in the two groups,and were contrasted.Then the relationships were analyzed between three kinds of indexes and POCD of elderly patients with general anesthesia. Results Compared with control group,the expression levels of S-100β protein and NES in POCD group at beginning of the operation （T1）,lasting 1 h （T2）,the end of the operation （T3）,24 h after operation （T4） highly increased and were higher than the levels before operation （T0） （ P 〈0.05）.The rSO 2 levels of POCD group and control group increased significantly during the operation and decreased at post-operation.The rSO 2 level of POCD group after operation was significantly lower than T0 and that of control group （ P 〈0.05）.S-100β protein and NES expression levels negatively correlated with Mini-menta State Examination score of elderly patients undergoing general anesthesia （ r = -0.684 ,-0.729）,while rSO 2 positively correlated with it （ r =0.891）. Conclusion The levels of S-100β protein,NES and rSO 2 had significant correlation with POCD in elderly patients undergoing general anesthesia,which could be used as reliable references for the early diagnosis of POCD.