老年患者术后认知功能障碍与IL-1β、IL-6和TNF-α的表达  

Postoperative cognitive dysfunction and expressions of IL-1β,IL-6 and TNF-α in the elderly

作　　者：杨泽勇[1] 徐莹华[1] 费凤英[2] 吕浩[3] 李泉[3] 杨立群[3] 俞卫锋[3] 

机构地区：[1]复旦大学附属中山医院青浦分院麻醉科,上海市201700 [2]复旦大学附属中山医院青浦分院检验科,上海市201700 [3]第二军医大学东方肝胆外科医院麻醉科

出　　处：《临床麻醉学杂志》2010年第9期764-766,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨骨科手术患者术后认知功能障碍(POCD)与白细胞介素-1β(IL-1β)、白细胞介素6(IL-6)和肿瘤坏死因子α(TNF-α)表达的关系。方法选择老年骨科全麻手术患者,年龄≥70岁,术前1d和术后2h采用简易智能状态检查量表(MMSE)评价患者认知功能,将术后2h认知功能评分相对于术前1d下降≥2分的患者归为POCD组(18例),无下降或上升的患者为对照组(21例)。采血检测IL-1β、IL-6和TNF-α。结果与对照组相比,POCD组术后2hMMSE评分明显下降(P<0.05),POCD组麻醉诱导前10minTNF-α和术后1dIL-6明显高于对照组(P<0.05)。与麻醉诱导前10min相比,POCD组TNF-α于术中1h、IL-6于术后2h和术后1d明显增高(P<0.05);对照组IL-6也于术后2h明显增高(P<0.05)。结论老年骨科手术患者发生术后认知障碍者伴随血中IL-6和TNF-α表达增强。Objective To investigate the relationship of postoperative cognitive dysfunction （POCD） and the expressions of interteukin（IL）-1β, IL-6 and TNFα in elder patients. Methods The patients （9 70 years old） undergoing orthopaedic surgery under general anesthesia were checked cognitive mark with mini-mental state examination （MMSE） at 1 d before operation and 2 h after operation. Compared with 1 d before operation, the patients with cognition score reduction 92 at 2 h after operation were arranged into POCD group（18 cases） and those without decrease in cognition score were arranged into control group（21 cases）. The levels of IL-1β, IL-6 and tumor necrosis factor-α（TNF-α） were detected. Results Compared with control group, MMSE score in POCD group was significantly reduced at 2 h after operation （P〈0.05）, TNF-α level at 10min prodnduction of anesthesia and 1 d post-operation were significantly higher in POCD group （P〈0.05）, and TNF-α level at 1 h en-operation and IL-6 at 2 h and 1 d posvoperation were significantly higher in POCD group as compared to the value at 10 min pro-indution of anesthesia （P〈0.05）. Conclusion Eider patients with POCD is associated with high expressions of II=6 and TNF-α.

关 键 词：术后认知障碍 老年 白细胞介素 肿瘤坏死因子Α 

分 类 号：R749.1[医药卫生—神经病学与精神病学]