老年患者脑脊液及血清分子标记物与术后早期认知功能障碍的关系  

Association of molecular biomarkers in cerebrospinal fluid and serum with early postoperative cognitive dysfunction in the elderly

作　　者：袁红梅[1] 李晓敏[2] 徐世霞[2] 努尔加马力[3] 韩玉英[3] 段满林[2] 朱伟[3] 

机构地区：[1]南京医科大学附属南京妇幼保健院,江苏省210004 [2]南京军区南京总医院麻醉科 [3]新疆伊犁州友谊医院麻醉科

出　　处：《江苏医药》2012年第23期2826-2828,共3页Jiangsu Medical Journal

基　　金：江苏省自然科学基金(BK2012778);新疆伊犁州科技局课题(YZ201101027)

摘　　要：目的研究老年患者脑脊液及血清分子标记物与术后早期认知功能障碍(POCD)的关系。方法选择腰麻下择期行全髋置换术患者43例,年龄65-85岁。患者于蛛网膜下腔穿刺成功后抽取脑脊液1ml,行Tau、Aβ淀粉样蛋白42(Aβ-42)、IL-1β及脑源性神经营养因子(BDNF)测定;于术后第7天行血清IL-1β及BDNF测定。术前及术后第7天采用简易精神状态量表(MMSE)评定认知功能,并以此将患者分为有POCD(A组)13例和无POCD(B组)30例。结果术后第7天13例有POCD,发生率为30.2%。与B组(30例)相比,A组术前脑脊液中IL-1β明显高于B组[(800±87)pg/ml vs.(654±56)pg/ml],而Aβ-42明显低于B组[(322±52)pg/ml vs.(427±67)pg/ml](P<0.05);两组脑脊液中Tau和BDNF及血清中IL-1β和BDNF差异无统计学意义(P>0.05)。结论老年患者术前脑脊液IL-1β升高及Aβ-42降低可能与术后早期POCD发生有关。Objective To investigate the association of molecular biomarkers in cerebrospinal fluid（CSF） and serum with early postoperative cognitive dysfunction（POCD） in the elderly.MethodsA total of 43 patients aged 65-85 years old underwent total hip replacement under spinal anesthesia.Cognitive function was evaluated with the mini-mental state examination（MMSE） before surgery and on th 7th day after surgery,on the basis of which the patients were assigned to groups of A（with POCD） and B（without POCD）.Tau,amyloid-β-42（Aβ-42）,interleukin-1β（IL-1β） and brain-derived neurotrophic factor（BDNF） in cerebrospinal fluid（CSF） before surgery and serum IL-1β and BDNF on th 7th day after surgery were determined.Results On th 7th day after surgery,POCD occurred in 13（30.2%） patients（group A）.Compared with group B（30 cases）,the patients in group A had higher IL-1β [（800±87） pg/ml vs.（654±56） pg/ml],but lower Aβ-42 levels in CSF[（322±52） pg/ml vs.（427±67） pg/ml]（P0.05）.There were no statistical differences in Tau and BDNF in CSF before surgery and serum levels of IL-1β and BDNF on th 7th day after surgery.Conclusion The early POCD in the elderly may be related with increased IL-1β and decreased Aβ-42 levels in CSF.

关 键 词：术后认知功能障碍 生物标记物 老年 

分 类 号：R741[医药卫生—神经病学与精神病学]