老年宫颈癌患者外周血S100A8水平和术后认知功能障碍发生的关系

Relationship between peripheral blood S100A8 level and postoperative cognitive dysfunction in elderly patients with cervical cancer

目的观察老年宫颈癌患者行全身麻醉术后认知功能障碍(postoperative cognitive dysfunction,POCD的发生情况,并探讨外周血S100A8表达变化与其发生的关系。方法选取全身麻醉下行择期开放性宫颈癌根治术的老年患者50例,年龄60~80岁。于术前1d和术后7d对患者及其一位健康家属进行两次认知功能测试,采用Z计分法判断患者术后7d是否出现POCD。于术前1d和术后7d采集患者外周血,采用qRT-PCR方法检测外周血单个核细胞(peripheral blood mononuclear Cells,PBMCs)中S100A8的表达水平。根据患者是否出现POCD,将患者分为POCD组和非POCD组,采用t检验分析两组患者术前术后S100A8表达改变和POCD发生的关系。结果50例老年患者中有12例出现POCD,发生率为24%。两组患者外周血的S100A8表达水平在术前差异无统计学意义(P>0.05);术后7d,POCD组的S100A8表达水平较术前以及较非POCD组差异有统计学意义(P<0.05),非POCD组的S100A8表达水平较术前差异无统计学意义(P>0.05)。结论老年宫颈癌患者早期POCD发生率较高,需引起足够重视。术后7d外周血S100A8水平与患者早期POCD的发生密切相关,并对其是否出现早期POCD可能有一定诊断价值。

Objective To observe the incidence of postoperative cognitive dysfunction(POCD)in elderly patients with cervical cancer after general anesthesia,and to explore the relationship between S100 A8 expression in peripheral blood and the occurrence of POCD.Methods Fifty elderly patients,aged 60-80 years,undergoing elective open radical operation for cervical cancer under general anesthesia were selected.The cognitive function of patients and a healthy family member of them were tested one day before operation and seven days after operation,and Z score method was used to judge whether POCD appeared in the patients seven days after operation.Patientsperipheral bloods were collected one day before and seven days after operation,and the expression levels of S100 A8 in peripheral blood mononuclear cells(PBMCs)were detected by qRT-PCR.According to whether patients had POCD,they were divided into POCD group and non-POCD group.T test was used to analyze the relationship between the changes of S100 A8 expression before and after operation and the occurrence of POCD.Results Twelve of 50 elderly patients had POCD,and the incidence rate was 24%.The expression levels of S100 A8 in peripheral blood of two groups had no significant difference before operation(P>0.05).Seven days after operation,the expression level of S100 A8 in POCD group was significantly higher than that before operation and that in non-POCD group(P<0.05),while the expression level of S100 A8 in non-POCD group had no obvious change compared with that before operation(P>0.05).Conclusion The incidence of early POCD in elderly patients with cervical cancer is high,which should be paid enough attention to.The level of S100 A8 in peripheral blood seven days after operation is closely related to the occurrence of early POCD in elderly patients with cervical cancer,and may have some diagnostic value for the occurrence of early POCD.