论文部分内容阅读
目的:观察行口腔颌面肿瘤切除手术的老年患者血浆中Aβ_(1-40)及S-100β在围术期的浓度变化及与术后认知功能障碍的相关性。方法:选择2014年5月—10月择期接受全身麻醉下行口腔颌面肿瘤切除手术的老年患者(年龄≥60岁)115例,所有入选患者于术前1 d、术后7 d行神经心理测试,判定患者是否发生术后认知功能障碍。测定所有患者麻醉诱导前及术后24 h、7 d血浆中Aβ_(1-40)及S-100β蛋白的含量,根据术后7 d是否发生POCD分为POCD组及非POCD组,观察Aβ_(1-40)及S-100β蛋白的含量与POCD的关系。采用SPSS19.0软件包对数据进行统计学分析。结果:POCD组术后7 d POCD的发病例数为37例(32.2%)。与术前比较,POCD组患者术后24 h POCD组患者S-100β含量显著升高(P<0.05);术后24 h血浆中S-100β及Aβ_(1-40)含量显著升高(P<0.05)。与非POCD组相比,POCD组患者术后24 h血浆中S-100β含量显著升高(P<0.05);术后24 h、7 d血浆中Aβ_(1-40)含量显著升高(P<0.05)。结论:Aβ_(1-40)、S-100β在术后升高可能与口腔颌面外科肿瘤切除术后POCD发病密切相关,术后血浆Aβ_(1-40)和S-100β浓度较术前持久增高明显者,发生POCD的可能性增加。Aβ_(1-40)、S-100β或许可作为行口腔肿瘤切除术患者术后POCD发病的预测指标。
OBJECTIVE: To observe the perioperative changes of plasma concentrations of Aβ 1-40 and S-100β in elderly patients undergoing oral and maxillofacial tumor resection and its correlation with postoperative cognitive dysfunction. Methods: A total of 115 elderly patients (≥60 years old) undergoing oral and maxillofacial tumor resection under general anesthesia were selected from May to October 2014. All selected patients underwent neuropsychological tests on day 1 and day 7 after operation. , To determine whether patients with postoperative cognitive dysfunction. The plasma levels of Aβ 1-40 and S-100β were measured before and 24 h and 7 d after anesthesia induction in all patients. According to whether POCD occurred on the 7th day after surgery, the patients were divided into two groups: POCD group and non-POCD group. Aβ_ ( 1-40) and S-100β protein content and POCD. SPSS19.0 software package for statistical analysis of the data. Results: The incidence of POCD in POCD group was 37 (32.2%) at 7 days after operation. Compared with the preoperative level, the content of S-100β in POCD group was significantly increased (P <0.05) at 24 h after operation in POCD group, while the levels of S-100β and Aβ 1-40 in POCD group were significantly increased at 24 h after operation <0.05). Compared with non-POCD group, the content of S-100β in plasma of patients in POCD group increased significantly (P <0.05) 24 h after operation; the content of Aβ 1-40 in plasma increased significantly at 24 h and 7 d <0.05). CONCLUSIONS: The elevated levels of Aβ 1-40 and S-100β may be closely related to the pathogenesis of POCD after oral and maxillofacial surgical resection. The postoperative levels of plasma Aβ 1-40 and S-100β are longer than preoperative Increased obviously, the possibility of POCD increased. Aβ_ (1-40) and S-100β may be used as predictors of postoperative POCD in patients undergoing oral tumor resection.