依达拉奉对老年髋关节置换术患者血清CXCL13水平及PND的影响

Effect of Edaravone on Serum CXCL13 Level and PND in Elderly Patients with Hip Replacement

目的评价依达拉奉对老年髋关节置换术患者外周血CXCL13水平及围术期神经认知障碍(PND)的影响。方法选择2016年3月~2018年3月于我院择期行髋关节置换术的老年患者160例,随机双盲分为依达拉奉组(E组)和对照组(C组),各80例;E组于术前30 min静脉注射依达拉奉,C组给予等量生理盐水。比较两组麻醉前、术中(切皮后30 min)、术后1、3、7 d血清CXCL13、IL-6浓度,术后1、3、7 d谵妄发生率,术后1个月及12个月的认知功能。结果两组术中、术后1、3、7 d血清CXCL13、IL-6浓度均高于麻醉前,差异有统计学意义(P<0.05);其中E组术中及术后1、3、7 d血清CXCL13、IL-6浓度均低于C组,差异有统计学意义(P<0.05);C组术后7 d谵妄发生率高于E组,差异有统计学意义(P<0.05);E组术后1、12个月TICS-M及ADL评分均高于C组,认知功能障碍发生率低于C组,差异有统计学意义(P<0.05)。结论老年髋关节置换患者围术期血清CXCL13、IL-6浓度升高,依达拉奉能降低患者血清CXCL13、IL-6浓度,并能改善患者围术期神经认知障碍及谵妄发生率。

Objective To evaluate the effects of edaravone on peripheral blood CXCL13 levels and perioperative neurocognitive disorder(PND)in elderly patients undergoing hip replacement surgery.Methods 160 elderly patients who underwent elective hip replacement surgery in our hospital from March 2016 to March 2018 were randomly and double-blindly divided into the edaravone group(group E)and the control group(group C),each with 80;Group E was given intravenous edaravone 30 min before surgery,and group C was given the same amount of saline.The serum CXCL13 and IL-6 concentrations were compared before,during(30 min after skin removal),1,3,and 7 d after anesthesia,and the incidence of delirium was observed at 1,3,and 7 d after surgery.Cognitive function at 1 and 12 months after surgery.Results The concentrations of serum CXCL13 and IL-6 in the two groups were higher than those before anesthesia during operation,1,3,and 7 d after operation,the difference was statistically significant(P<0.05);the serum CXCL13 and IL-6 concentrations in group E were lower than those in group C during operation and 1,3,and 7 d after surgery,the difference was statistically significant(P<0.05);the incidence of delirium was higher in group C at 7 d after operation than in group E,the difference was statistically significant(P<0.05);TICS-M and ADL at group E at 1 and 12 months after operation The scores were higher than those of group C,and the incidence of cognitive dysfunction was lower than that of group C,the difference was statistically significant(P<0.05).Conclusion The serum CXCL13 and IL-6 concentrations of elderly hip joint replacement patients increased during perioperative period.Edaravone can reduce the serum CXCL13 and IL-6 concentrations and improve the incidence of neurocognitive disorders and delirium during perioperative period.