参麦注射液对肺癌患者术后认知功能障碍及血清神经元特异性烯醇化酶水平的影响

Effect of Shenmai Injection on Postoperative Cognitive Dysfunction and Levels of Neuron-Specific Enolase in Serum in Patients with Lung Cancer

目的:观察参麦注射液对肺癌患者术后认知功能障碍(POCD)及血清神经元特异性烯醇化酶(NSE)水平的影响。方法:选取80例肺癌患者为研究对象,随机分为研究组和对照组各40例。麻醉诱导后,研究组给予静脉滴注参麦注射液治疗,对照组给予静脉滴注葡萄糖溶液治疗。比较2组不良反应发生率,以及手术前后焦虑自评量表(SAS)、简易智能精神状态检查量表(MMSE)、抑郁自评量表(SDS)评分及POCD发生率、血清NSE、C-反应蛋白(CRP)水平。结果:术前1 d,2组MMSE评分比较,差异无统计学意义(P>0.05)。术后1、3、7 d,2组MMSE评分均较手术前1 d降低(P<0.05),并呈上升趋势(P<0.05);且研究组在相同时间点MMSE评分均高于对照组(P<0.05)。术前1 d,2组SAS、SDS评分比较,差异无统计学意义(P>0.05);术后1、3、7 d,2组SAS、SDS评分均较术前1 d升高(P<0.05),并呈升高趋势(P<0.05),而研究组在相同时间点SAS、SDS评分均低于对照组(P<0.05)。术后1 d,2组POCD发生率比较,差异无统计学意义(P>0.05)。术后3、7 d,2组POCD发生率均较术后1 d降低(P<0.05),并呈下降趋势(P<0.05);且研究组在相同时间点POCD发生率均低于对照组(P<0.05)。术前1 d,2组血清NSE、CRP水平比较,差异无统计学意义(P>0.05)。术后1、3 d,2组血清NSE、CRP水平均较术前1 d升高(P<0.05),并呈先升高后降低的趋势(P<0.05),且研究组在相同时间点NSE、CRP水平均低于对照组(P<0.05)。研究组不良反应发生率为2.50%,对照组为5.00%,2组比较,差异无统计学意义(P>0.05)。结论:观察参麦注射液可有效改善肺癌术后并发POCD,改善患者认知能力,降低炎症水平,缓解焦虑和抑郁情绪。

Objective:To observe the effect of Shenmai Injection on postoperative cognitive dysfunction(POCD) and levels of neuron-specific enolase(NSE) in serum in patients with lung cancer.Methods:A total of 80 cases of patients with lung cancer were selected as the study subjects,and randomly divided into the study group and the control group,with 40 cases in each group.After anesthesia induction,the study group was treated with intravenous infusion of Shenmai Injection,and the control group was treated with intravenous infusion of glucose solution.The scores of the Self-rating Anxiety Scale(SAS),Mini-Mental State Examination(MMSE),Self-rating Depression Scale(SDS) before and after surgery,as well as the incidence of POCD,and levels of NSE and C-reactive protein(CRP) in serum,and the incidence of adverse reactions were compared between the two groups.Results:There was no significant difference being found in the comparison of MMSE scores between the two groups one day before surgery(P>0.05).On the first,third,and seventh day after surgery,the MMSE scores in the two groups were decreased when compared with those at the first day before surgery(P<0.05),and showed an upward trend(P<0.05);the MMSE scores in the study group were higher than those in the control group at the same time point(P<0.05).On the first day before surgery,there was no significant difference being found in the comparison of scores of SAS and SDS between the two groups(P<0.05);on the first,third,and seventh day after surgery,the scores of SAS and SDS in the two groups were increased when compared with those on the first day before surgery(P<0.05),and showed an upward trend(P<0.05).At the same time point,the scores of SAS and SDS in the study group were lower than those in the control group(P<0.05).There was no significant difference being found in the comparison of incidence of POCD between the two groups one day after surgery(P>0.05).On the third and seventh day after surgery,the incidence of POCD in the two groups were decreased when compared with those on the first day after surgery(P<0.05),and showed a downward trend(P<0.05);the incidence of POCD in the study group was lower than that in the control group at the same time point(P<0.05).On the first day before surgery,there was no significant difference being found in the comparison of levels of NSE and CRP in serum between the two groups(P>0.05).On the first and third day after surgery,the levels of NSE and CRP in serum in the two groups were increased when compared with those on the first day before surgery(P<0.05),and showed a trend of first increasing and then decreasing(P<0.05);the levels of NSE and CRP in serum in the study group were lower than those in the control group at the same time point(P<0.05).The incidence of adverse reactions was 2.50% in the study group,and 5.00% in the control group,there being no significant difference(P>0.05).Conclusion:Shenmai Injection can effectively improve POCD in patients with lung cancer,enhance cognitive ability,reduce inflammation levels,and alleviate anxiety and depression.