灯盏花素预处理对脑膜瘤切除患者脑保护作用及睡眠质量的影响

Effects of Breviscapine Pretreatment on Brain Protection and Sleep Quality in Patients with Meningioma Resection

目的:评价灯盏花素预处理对脑膜瘤切除术患者围术期血清白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)水平及术后认知功能和睡眠质量的影响。方法:选取2017年7月至2018年8月广州医科大学附属第二医院收治的ASA分级I-II级择期行脑膜瘤切除术的患者40例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组20例,对照组用生理盐水处理,观察组用灯盏花素预处理。2组患者均采用气管插管全身麻醉,患者于预处理完毕即刻(T1)、预处理后24 h(T2)、48 h(T4)及术后72 h(T4)抽取静脉血,测定血清IL-6和IL-8、TNF-α水平,记录患者生命体征平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)、脑电双频指数(BIS)、呼末二氧化碳(PETCO2),并且分别术前1 d和术后3 d对2组患者均采用MMSE、MocA量表进行神经认知功能评价及评估匹兹堡睡眠质量指数(PSQI)评估。结果:2组患者年龄、身高、体质量、ASA分级、术前匹兹堡睡眠质量指数差异无统计学意义(P>0.05),观察组IL-6和IL-8、TNF-α的水平明显低于对照组(P<0.05),观察组与对照组患者术后认知功能均有所损害,但观察组患者术后认知功能评分、匹兹堡睡眠质量指数明显优于对照组(P<0.05)。结论:灯盏花素预处理可以降低脑膜瘤切除术患者血清中IL-6和IL-8、TNF-α水平,可以改善患者术后认知功能及术后睡眠质量。

Objective:To evaluate the effects of breviscapine pretreatment on serum levels of interleukin6(IL-6),interleukin8(IL-8)and TNF-a(TNF-a)and postoperative cognitive function and sleep in patients undergoing meningioma resection.Methods:Forty received elective meningioma resection patients of ASA grade I-II were randomly divided into two groups:Breviscapine pretreatment group(D group)and Control group(C group).Both groups received general anesthesia with endotracheal intubation,Venous blood was extracted immediately after pretreatment(T1),24 h after pretreatment(T2),48 h after pretreatment(T4)and 72 h after pretreatment(T4),then injected into a tube for centrifugation,serum was separated,stored at-80℃,and the levels of IL-6,IL-8 and TNF-a were determined by radioimmunoassay.Cognitive function was evaluated on the first day and the third day after surgery.Record the patients average arterial pressure(MAP),heart rate(HR),oxygen saturation(SpO2),bispectral index(BIS).Results:The levels of IL-6,IL-8 and TNF-a in group D were significantly lower than those in group C(P<0.05).Conclusion:Breviscapine pretreatment can reduce serum levels of IL-6,IL-8 and TNF-a in patients with meningioma resection,and improve postoperative cognitive function and sleep.