血清NSE、S100β与术后谵妄关系研究

Study on correlation between serum NSE,S100β and postoperative delirium

目的研究全身麻醉患者血浆神经元特异性烯醇化酶(NSE)、S100β与术后谵妄(PD)的关系。方法 45例择期全身麻醉患者(非心脏手术),于术前1 d和术后采用意识错乱评估法(CAM)进行谵妄状态评定,术后发生谵妄的患者为谵妄组(18例),未发生谵妄的患者为对照组(27例)。并分别于术前、术后1d抽取两组血清测定NSE、S100β。结果两组患者术前1d的简易精神状态量表(MMSE)评分比较,差异无统计学意义(P>0.05)。术后谵妄组的MMSE评分为(17.67±11.93)分,低于对照组的(24.93±0.70)分,差异有统计学意义(P<0.05)。谵妄组和对照组术前血清S100β测量值比较,差异无统计学意义(P>0.05);谵妄组和对照组术后血清S100β变化值比较,差异无统计学意义(P>0.05);两组手术前后血清S100β差值比较,差异有统计学意义(P<0.05)。术前谵妄组和对照组NSE值比较,差异无统计血意义(P>0.05);术后谵妄组和对照组NSE值比较,差异无统计血意义(P>0.05);两组手术前后NSE差值比较,差异无统计学意义(P>0.05)。结论血清NSE与苏醒期谵妄发生无明确关系;血清S100β蛋白与苏醒期谵妄发生有一定相关性。

Objective To study the correlation between serum neuron specific enolase(NSE),S100βand postoperative delirium(PD)in general anesthesia patients.Methods A total of45patients with selectivegeneral anesthesia(non-cardiac surgery)received delirium condition assessment by confusion assessmentmethod(CAM)in preoperative1d and postoperation,and patients with postoperative delirium as deliriumgroup(18cases)and patients without delirium as control group(27cases).Detection were made on NSE andS100βin preoperation and postoperative1d in two groups.Results Both groups had no statistically significantdifference in mini-mental state examination(MMSE)score in postoperative1d(P>0.05).The delirium grouphad lower postoperative MMSE score as(17.67±11.93)points than(24.93±0.70)points in the control group,and the difference had statistical significance(P<0.05).The delirium group and control group had no statisticallysignificant difference in serum S100βtest value before operation(P>0.05).The delirium group and control grouphad no statistically significant difference in preoperative serum S100βchange value(P>0.05).Both groups hadstatistically significant difference in serum S100βdifference value before and after operation(P<0.05).Thedelirium group and control group had no statistically significant difference in NSE value before operation(P>0.05).The delirium group and control group had no statistically significant difference in NSE value after operation(P>0.05).Both groups had no statistically significant difference in NSE difference value before and after operation(P>0.05).Conclusion Serum NSE has no certain correlation between serum NSE and emergence delirium,andserum S100βprotein has certain correlation with emergence delirium.