摘要: |
目的:探讨气管插管全麻手术后患者术后认知功能障碍(postoperative cognitive dysfunction,POCD)与外周血中血管内皮生长因子(vascular endothelial growth factor,VEGF)水平变化的相关性。
方法:选择老年骨科手术患者,年龄≥65岁,无心脑血管疾病和精神类药物使用史。术前1 d和术后2 h分别采用简易精神状态检查表(mini mental state examination,MMSE)评分,明确患者的认知功能情况。实验分为两组:POCD组20例,对照组22例。分别于麻醉诱导前10 min、术中1 h、术后2 h和术后1 d采集外周血,检测VEGF水平。
结果:两组患者的一般情况无明显差异。与术前相比,POCD组术后2 h的MMSE评分明显降低(P<0.001),而对照组差异不明显。与对照组相比,术后2 h时POCD组的VEGF水平明显升高(P<0.01);而在其余时间点POCD组与对照组间VEGF差异无统计学意义。
结论:骨科老年患者全麻手术后2 h POCD的发生与术后2 h外周血中VEGF表达水平升高相关。 |
关键词: 认知障碍 麻醉,全身 血管内皮生长因子 |
DOI:10.12025/j.issn.1008-6358.2016.20160813 |
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Abstract: |
Objective:To explore the correlationship between the change of vascular endothelial growth factor (VEGF) level in peripheral blood and postoperative cognitive dysfunction (POCD) in patients with tracheal intubation under general anesthesia.
Methods:The elderly patients (age≥65) undergoing orthopaedics surgery with no cardiovascular disease and antidepressant disease history were selected. The cognitive function of patients was scored by mini mental state examination (MMSE) at 1 d before operation and 2 h after operation. There were two groups: POCD group (n=20) and control group (n=22). The level of VEGF in peripheral blood was detected in 10 min before anesthesia induction, 1 h during operation, 2 h and 1 d after operation, respectively.
Results:There was no significant difference in demographic data between the two groups. MMSE score was significantly lower 2 h after operation than before operation in POCD group (P<0.001), but there was no significant difference between pre operation and post operation in the control group. VEGF level was significantly increased 2 h after operation compared with that before operation in POCD group (P<0.01), but there was no significant changes between the control group and POCD group at other time points.
Conclusions:For the elderly patients undergoing orthopaedics operation under general anesthesia, the early POCD may be associated with the elevated expression of VEGF in peripheral blood 2 h after operation. |
Key words: cognition disorders general anesthesia vascular endothelial growth factor |