α-硫辛酸对糖尿病患者冠状动脉搭桥术后认知障碍的影响  

Effects of a- lipoic acid on cognitive dysfunction in elder diabetes patients undergoing coronary artery bypass grafting

作　　者：尹光明[1] 梁卫东[2] 

机构地区：[1]济宁医学院附属医院麻醉科,山东济宁272029 [2]济宁医学院附属医院肾内二科

出　　处：《中国实用医刊》2011年第18期22-23,共2页Chinese Journal of Practical Medicine

摘　　要：目的研究a-硫辛酸对糖尿病患者冠状动脉搭桥术后认知障碍的影响。方法将30例65岁以上择期行冠状动脉搭桥术的糖尿病患者随机分为对照组（c组）和a-硫辛酸组（L组），每组15例。L组于体外循环前静脉注入a-硫辛酸50mg／kg，C组静脉注入等容量生理盐水。分别于术前，术毕，术后6、12、48h测定血清S10013及神经元特异性烯醇化酶（NSE）含量。于术前及术后1周进行认知功能测定。结果两组患者血清S100β及NSE含量在手术结束时明显增高，术后6h含量最高，相同时间点L组明显低于c组；术后C组有12例发生认知功能障碍，L组患者有4例发生认知功能障碍。结论（a-硫辛酸可降低行冠状动脉搭桥术糖尿病患者血清S100β及NSE含量，降低患者术后认知功能障碍的发生率。Objective To study the effects of a-lipoic acid on cognitive dysfunction in elder diabetes patients undergoing coronary artery bypass grafting（CABG）. Methods Thirty diabetes patients older than 65 years old were randomly divided into a- lipoicacid group （ group L, n = 15 ） and control group（ group C, n = 15 ）. After tracheal intubation, o~ -lipoic acid 600 mg was administered intravenously in group L, while in group C only equivalent of normal saline was administered. Blood samples were taken before operation, at the end of surgery, 6 h, 24 h and 48 h after operation for measurement of plasma S100β, neuron- specific enolase concentration. Neurocognitive testing was performed before operation, at one week after operation. Results Serum levels of S100 and NSE were markedly increased at the end of surgery, and reached at peak values at 6 h after operation in both groups, but the levels in group L were significantly lower than those in group C at the same stage（ P 〈0.01 ）. There were 12 patients suffered from early cognitive dysfunction in group C, and 4 cases in group L. Conclusions Pretreatment with α - lipoic acid is effective in reducing cerebral neurologic injuries in elder diabetes patients undergoing coronary artery bypass grafting.

关 键 词：冠状动脉搭桥术 认知功能障碍 糖尿病 A-硫辛酸 

分 类 号：R587.1[医药卫生—内分泌] R654.2[医药卫生—内科学]