依达拉奉对老年髋关节置换术患者POCD的预防作用及其对脑损伤相关蛋白的影响

Effect of edaravone on the prevention of POCD and related protein of brain damage in elderly patients undergoing hip replacement

目的分析依达拉奉对老年髋关节置换术患者术后认知功能障碍(POCD)的预防作用及其对S100-β蛋白、神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)的影响。方法选取2017年12月至2018年11月我院收治的80例老年髋关节置换术患者作为研究对象。根据随机数字表原则,将患者分为对照组和观察组,每组40例。对照组患者给予常规麻醉,观察组患者在麻醉诱导前静脉输注依达拉奉30mg。对比两组患者术前24h(T0)、术后24h(T1)、术后7d(T2)时的简易精神状态检查量表(MMSE)评分,对比两组患者T0、T1时血清S100-β蛋白、NSE、GFAP水平及POCD发生率。结果两组患者T1、T2时MMSE评分均低于T0时(P<0.05)。观察组患者T1、T2时MMSE评分高于对照组,POCD发生率低于对照组,差异均有统计学意义(P<0.05)。两组患者T1时S100-β蛋白、NSE、GFAP水平均高于T0时(P<0.05)。观察组患者T1时S100-β蛋白、NSE、GFAP水平低于对照组(P<0.05)。结论麻醉诱导前静脉给予依达拉奉可降低老年髋关节置换术患者POCD发生率,改善MMSE评分,降低血清S100-β蛋白、NSE、GFAP水平。

Objective To analyze the preventive effect of edaravone on postoperative cognitive dysfunction ( POCD) in elderly patients undergoing hip replacement and its influence on S100-β protein,neuron specific enolase ( NSE) and glial fibrillary acidic protein ( GFAP). Methods Totally 80 elderly patients with hip replacement who were admitted to our hospital from December 2017 to November 2018 were selected as subjects. According to the principle of random number table,patients were divided into control group and observation group, 40 cases in each group. Patients in control group were given routine anesthesia,while the patients in observation group were intravenously infused with edaravone 30 mg before induction of anesthesia. The MMSE ( Mini-mental state examination,MMSE) scores between the two groups were compared at 24 h before surgery ( T0 ), 24 h after surgery ( T1 ), and 7 d after surgery ( T2 ). The levels of serum S100-β protein,NSE and GFAP at T0 and T1 were compared between the two groups. The incidence of POCD was compared between the two groups. Results The MMSE scores at T1 and T2 of the two groups were lower than those at T0 ( P < 0. 05), and observation group was higher than control group ( P < 0. 05). The incidence of POCD in observation group was lower than that in control group ( P < 0. 05). The levels of S100-β protein, NSE and GFAP in the two groups at T1 were higher than those at T0 ( P < 0. 05), and observation group was lower than control group ( P < 0. 05). Conclusion Intravenous edaravone before anesthesia induction can reduce the incidence of POCD in elderly patients undergoing hip replacement, improve MMSE score, and decrease the levels of serum S100-β protein,NSE and GFAP.