依托咪酯对老年股骨颈骨折患者皮质醇与氧化应激因子及认知功能的影响

Effects of etomidate on cortisol, oxidative stress factors and cognitive function in elderly patients with femoral neck fractures

目的探讨依托咪酯对老年股骨颈骨折患者皮质醇与氧化应激因子及认知功能的影响。方法选择2016年3月-2017年3月在本院行股骨颈骨折手术的患者40例作为研究对象,采用依托咪酯进行麻醉诱导和维持,并采用等比抽样法选取2015年3月-2016年3月采用丙泊酚进行麻醉诱导和维持的40例患者作为对照组,采用放射性免疫吸附法检测患者皮质醇、氧化应激因子水平,评价患者认知功能。结果术后MDA、AOPP均较前下降,且观察组低于对照组;术后抗氧化物GSH-PX、SOD较前明显上升,术后1d、4d、7d2组患者皮质醇水平均较前明显增高,观察组明显低于对照组,以上差异均有统计学意义(P<0.05)。结论股骨颈骨折手术的患者,采用依托咪酯进行麻醉诱导和维持有助于降低患者皮质醇、氧化应激水平、改善患者认知功能。

Objective To investigate the effects of etomidate on cortisol, oxidative stress and cognitive function in elderly patients with femoral neck fractures. Methods Forty patients with femoral or neck fracture who underwent surgery were selected as subjects during March 2016-March 2017 from the Affiliated Hospital of Yan'an University, and etomidate was used for induction and m aintenance of anesthesia. Forty patients with propofol induction and m aintenance were selected as the control group by equal sam pling method during March 2015-March 2016. The levels of cortisol and oxidative stress factors were measured by radioim m unoassay, and the cognitive function of patients was evaluated. Results The postoperative MDA and AOPP decreased, and that in the observation group was lower than that in the control group. The postoperative antioxidant GSH-PX and SOD increased significantly, and the cortisol levels were significantly higher than before in the two groups at 1 d , 4 d , and 7 d after operation, and that in the observation group was significantly lower than that in the control group, with the above differences statistically significant ( P < 0 . 05 ). Conclusion The use of etom idate in elderly patients with femoral neck fractures can help reduce cortisol, oxidative stress levels and improve cognitive function in patients with femoral neck fractures.