携带ApoEε4、BACE1基因SNP患者发生全麻后认知功能障碍与增龄的关系  

Relationship between the increase of age and cognitive dysfunction in patients with ApoE and BACE1 gene single nucleotide polymorphism after general anesthesia

作　　者：蔡英敏[1] 张勇[1] 张蓬勃[1] 李伟[1] 李思远[1] 张瑛[1] 董小章[1] 

机构地区：[1]西安交通大学第二附属医院麻醉科,西安710004

出　　处：《山西医科大学学报》2013年第8期591-595,共5页Journal of Shanxi Medical University

基　　金：国家自然科学基金资助项目(81171247)

摘　　要：目的研究携带ApoEε4、BACE1基因单核苷酸多态性(SNP)患者发生全麻后认知功能障碍与增龄的关系。方法应用PCR技术检测ApoE、BACE1基因单核苷酸多态性,通过基因筛查,选择携带ApoEε4及BACE1 G/C等位基因的老年组、中青年组各50例患者,接受静吸复合麻醉后,用简易精神量表对其术后3 d认知功能进行MMSE评分(评分<25被认为有认知功能障碍),将评分进行统计学分析。结果中青年组患者术前、术后MMSE评分均高于25,而老年组患者术后3 d的MMSE评分较术前及中青年组同时间的MMSE评分均明显降低(P<0.01);老年组患者术后第一天MMSE评分≤25的患者人数占该组总人数的比例明显多于中青年组(96%vs 18%,P<0.01);老年组术后3 d出现认知功能障碍的人数为48例,而中青年组只有9例,两组比较差异有统计学意义(P<0.01)。结论年龄与携带ApoEε4、BACE1基因SNP患者发生全麻后认知功能障碍有密切关系,老年人是易患人群。Objective To explore the relationship between the increase of age and the cognitive dysfunction of patients with ApoE and BACE1 gene single nucleotide polymorphism（SNP） after general anesthesia. Methods ApoE and BACE! gene single nucleotide pol- ymorphisms were detected with PCR. Through genetic screening,50 aged patients and 50 adult patients with ApoEε4 and BACE1 G/C were enrolled. Three days after general anesthesia, cognitive function was evaluated with mini-mental state examination （MMSE） and an- alyzed. Results The preoperative and postoperative MMSE scores were both higher than 25 in adult group. The postoperative MMSE score in aged group was significantly decreased after general anesthesia（ P 〈 0.01 ）, and it was significantly lower than that in adult group（P 〈0.01 ）. The proportion of MMSE score 〈25 at day 1 after operation in aged group was higher than in adult group （96% vs 18% ,P 〈0.01 ）. The incidence of cognitive dysfunction in aged group in 3 d after general anesthesia was higher than that in adult group（P 〈 0.01 ）. Conclusion The age is closely related to cognitive dysfunction after general anesthesia in patients with ApoE~,4 and BACE1 gene SNPs,especially in the aged patients.

关 键 词：认识功能障碍 全身麻醉 APOE BACE1 单核苷酸多态性 

分 类 号：R614[医药卫生—麻醉学]