老年全身麻醉患者血清S-100β蛋白、神经元特异性烯醇化酶及脑氧饱和度与认知功能障碍的相关性

摘要

Objective To explore the relationships between levels of S-100β protein,neuron-specific enolase (NSE),cerebral oxygen saturation(rSO2)and postoperative cognitive dysfunction(POCD)of elderly patients undergoing general anesthesia.Methods A total of 127 elderly patients undergoing general anesthesia were selected as study objects,and were divided into POCD group(63 cases)and control group(64 cases).Serum S-100β protein,NES and rSO2levels were detected respectively at preoperative,intraoperative and postopera-tive in the two groups,and were contrasted.Then the relationships were analyzed between three kinds of inde-xes and POCD of elderly patients with general anesthesia.Results Compared with control group,the expres-sion levels of S-100β protein and NES in POCD group at beginning of the operation(T1),lasting 1 h(T2),the end of the operation(T3),24 h after operation(T4)highly increased and were higher than the levels before operation(T0)(P<0.05).The rSO2levels of POCD group and control group increased significantly during the operation and decreased at post-operation.The rSO2level of POCD group after operation was significantly lower than T0 and that of control group(P<0.05).S-100β protein and NES expression levels negatively cor-related with Mini-menta State Examination score of elderly patients undergoing general anesthesia(r=-0.684,-0.729),while rSO2positively correlated with it(r=0.891).Conclusion The levels of S-100β pro-tein,NES and rSO2had significant correlation with POCD in elderly patients undergoing general anesthesia, w hich could be used as reliable references for the early diagnosis of POCD.%目的 探讨老年全身麻醉患者血清S-100β蛋白、神经元特异性烯醇化酶(NSE)及脑氧饱和度(rSO2)与术后认知功能障碍(POCD)的相关性.方法 选取该院127例选择全身麻醉进行手术的老年患者为研究对象,分为POCD组63例和对照组64例,分别检测2组患者术前、术中及术后血清S-100β蛋白、NES及rSO2水平,并进行比对,分析3项检测指标与老年全身麻醉患者 POCD 的相关性.结果 与对照组相比, POCD组患者血清S-100β和NES在手术开始时刻(T1)、手术进行1 h(T2)、术毕(T3)和术后24 h(T4)均明显升高,且明显高于麻醉诱导前(T0)(P<0.05);2组患者rSO2水平在术中明显升高,并在术后降低,且POCD组术后rSO2水平明显低于对照组及其T0时水平(P<0.05);血清S-100β蛋白和NES水平与老年全身麻醉患者M M SE评分呈负相关(r= -0.684、-0.729),而rSO2则与患者简易智力精神状态量表评分呈正相关(r=0.891).结论 老年全身麻醉患者血清 S-100β蛋白、NES 和 rSO2均与 POCD 明显相关,可作为早期诊断POCD的参考依据.