目的探讨老年脑肿瘤患者围术期神经认知障碍(PND)发生的影响因素及康复治疗的有效性。方法回顾性分析新疆医科大学第一附属医院2020年12月至2022年7月收治的120例老年脑肿瘤患者的临床资料,按是否发生PND将患者分为PND组(n=78)和非PND组...目的探讨老年脑肿瘤患者围术期神经认知障碍(PND)发生的影响因素及康复治疗的有效性。方法回顾性分析新疆医科大学第一附属医院2020年12月至2022年7月收治的120例老年脑肿瘤患者的临床资料,按是否发生PND将患者分为PND组(n=78)和非PND组(n=42),比较两组人口学信息及相关临床指标。按照干预方式,将PND组患者分为对照组(n=41)与观察组(n=37),比较不同干预方法在改善PND患者神经认知功能及生活质量中的效果。采用SPSS 22.0统计软件进行数据处理。根据数据类型,分别采用t检验或χ^(2)检验进行组间比较。采用多因素logistic回归模型分析老年脑肿瘤患者发生PND的影响因素。结果老年脑肿瘤患者PND发生率为65.0%(78/120)。PND组与非PND组患者年龄、肿瘤部位、WHO肿瘤病理分级及肿瘤体积比较,差异有统计学意义(P<0.05)。治疗后,观察组中文版蒙特利尔认知评估量表(MoCA)评分高于对照组;角色、躯体、社会及情绪功能评分高于对照组,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示:老年脑肿瘤患者PND发生的影响因素为肿瘤部位(OR=1.879,95%CI 1.103~3.203)、WHO肿瘤病理分级(Ⅱ级:OR=1.964,95%CI 1.021~3.780;Ⅲ级:OR=2.186,95%CI 1.099~4.349;Ⅳ级:OR=2.462,95%CI 1.162~5.216)及肿瘤体积(20~<40 cm 3:OR=1.793,95%CI 1.016~3.166;40~<60 cm 3:OR=2.038,95%CI 1.114~3.727;≥60 cm 3:OR=2.207,95%CI 1.207~4.298)。结论老年脑肿瘤患者PND发生率较高,尤以肿瘤部位处于额颞叶、WHO肿瘤病理分级高及肿瘤体积大的脑肿瘤患者为高危人群,需重点关注,在PND发生后,给予康复治疗有利于神经认知功能的改善。展开更多
Objective:To investigate whether remifentanil induced cardioprotecting effect is associated with expression of toll-like receptor 4(TLR4),nuclear factor κB(NF-κB) and serum interleukin-6(IL-6).Methods:Fifty rabbits ...Objective:To investigate whether remifentanil induced cardioprotecting effect is associated with expression of toll-like receptor 4(TLR4),nuclear factor κB(NF-κB) and serum interleukin-6(IL-6).Methods:Fifty rabbits were randomly divided into 5 groups(n=10) according to the treatment:sham operation group(group A),ischemia-reperfusion group(group B),low-dose remifentanil group(group C),mediate-dose remifentanil group(group D),and high-dose remifentanil group(group E).Myocardial TLR4 mRNA levels,NF-κB protein expression and serum levels of IL-6 were observed in 120 min after reperfusion.Results:The myocardial expressions of TLR4 mRNA,NF-κB protein and IL-6 level in sera of groups B,C,D and E were elevated compared with group A.However,remifentanil significantly reduced the levels of TLR4 mRNA,NF-κB protein expression and serum IL-6 in groups C,D and E compared with group B.There were remarkable differences between the groups(P<0.01).Conclusion:Intravenous remifentanil has protective effect against rabbit myocardial ischemia/reperfusion injury.This effect may be associated with TLR4,NF-κB expressions on myocytes and serum level of IL-6 in a dose-dependent manner.展开更多
文摘目的探讨老年脑肿瘤患者围术期神经认知障碍(PND)发生的影响因素及康复治疗的有效性。方法回顾性分析新疆医科大学第一附属医院2020年12月至2022年7月收治的120例老年脑肿瘤患者的临床资料,按是否发生PND将患者分为PND组(n=78)和非PND组(n=42),比较两组人口学信息及相关临床指标。按照干预方式,将PND组患者分为对照组(n=41)与观察组(n=37),比较不同干预方法在改善PND患者神经认知功能及生活质量中的效果。采用SPSS 22.0统计软件进行数据处理。根据数据类型,分别采用t检验或χ^(2)检验进行组间比较。采用多因素logistic回归模型分析老年脑肿瘤患者发生PND的影响因素。结果老年脑肿瘤患者PND发生率为65.0%(78/120)。PND组与非PND组患者年龄、肿瘤部位、WHO肿瘤病理分级及肿瘤体积比较,差异有统计学意义(P<0.05)。治疗后,观察组中文版蒙特利尔认知评估量表(MoCA)评分高于对照组;角色、躯体、社会及情绪功能评分高于对照组,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示:老年脑肿瘤患者PND发生的影响因素为肿瘤部位(OR=1.879,95%CI 1.103~3.203)、WHO肿瘤病理分级(Ⅱ级:OR=1.964,95%CI 1.021~3.780;Ⅲ级:OR=2.186,95%CI 1.099~4.349;Ⅳ级:OR=2.462,95%CI 1.162~5.216)及肿瘤体积(20~<40 cm 3:OR=1.793,95%CI 1.016~3.166;40~<60 cm 3:OR=2.038,95%CI 1.114~3.727;≥60 cm 3:OR=2.207,95%CI 1.207~4.298)。结论老年脑肿瘤患者PND发生率较高,尤以肿瘤部位处于额颞叶、WHO肿瘤病理分级高及肿瘤体积大的脑肿瘤患者为高危人群,需重点关注,在PND发生后,给予康复治疗有利于神经认知功能的改善。
基金Supported by Shaanxi Provincial Scientific and Technological Research Projects (2008K13-02)
文摘Objective:To investigate whether remifentanil induced cardioprotecting effect is associated with expression of toll-like receptor 4(TLR4),nuclear factor κB(NF-κB) and serum interleukin-6(IL-6).Methods:Fifty rabbits were randomly divided into 5 groups(n=10) according to the treatment:sham operation group(group A),ischemia-reperfusion group(group B),low-dose remifentanil group(group C),mediate-dose remifentanil group(group D),and high-dose remifentanil group(group E).Myocardial TLR4 mRNA levels,NF-κB protein expression and serum levels of IL-6 were observed in 120 min after reperfusion.Results:The myocardial expressions of TLR4 mRNA,NF-κB protein and IL-6 level in sera of groups B,C,D and E were elevated compared with group A.However,remifentanil significantly reduced the levels of TLR4 mRNA,NF-κB protein expression and serum IL-6 in groups C,D and E compared with group B.There were remarkable differences between the groups(P<0.01).Conclusion:Intravenous remifentanil has protective effect against rabbit myocardial ischemia/reperfusion injury.This effect may be associated with TLR4,NF-κB expressions on myocytes and serum level of IL-6 in a dose-dependent manner.
