异丙酚全身麻醉对老年患者血清神经元特异性烯醇化酶、S100B蛋白及认知功能的影响  

Effect of propofol general anesthesia on neuron-specific enolase( NSE) in blood serum,S100B protein and cognitive function of gerontal patients

作　　者：黄月球[1] 

机构地区：[1]浙江省台州学院医学院附属天台医院麻醉科,浙江天台317200

出　　处：《实用药物与临床》2014年第6期708-710,共3页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨异丙酚全身麻醉对老年患者血清神经元特异性烯醇化酶(NSE)、S100B蛋白及认知功能的影响。方法选择68例择期行手术治疗的老年患者,随机分为七氟醚组和异丙酚组,每组34例。分别使用七氟醚和异丙酚全身麻醉。结果两组术后4、24 h血清NSE和S100B蛋白水平均较麻醉前明显上升(P<0.05或P<0.01),且异丙酚组上升幅度明显低于七氟醚组(P<0.05)。两组术后48 h血清NSE和S100B蛋白水平均恢复到麻醉前水平(P>0.05);同时两组术后4、24 h简易智能量表(MMSE)评分均较麻醉前明显下降(P<0.05或P<0.01),且异丙酚组下降幅度明显低于七氟醚组(P<0.05)。两组术后48 h MMSE评分均恢复到麻醉前水平(P>0.05)。结论七氟醚和异丙酚麻醉均可降低老年患者术后早期的认知功能,但异丙酚的影响较少,更适合于老年患者,作用与其能降低患者血清NSE和S100B蛋白水平密切相关。Objective To discuss the effect of propofol general anesthesia on neuron-specific enolase（ NSE） in blood serum,S100B protein and cognitive function of gerontal patients. Methods 68 cases of gerontal patients underwent elective surgery were divided into sevoflurane group and propofol group at random,34 cases in each group and were given the general anesthesia with sevoflurane and propofol separately. Results After postoperative 4 and 24 hours,compared with pre-anesthesia condition,the NSE in blood serum and S100B protein rose sharply（ P〈0. 05 or P 0. 01）,and the rising rate in propofol group was obviously lower than that in sevoflurane group（ P〈0. 05）. After postoperative 48 hours,the condition of NSE in blood serum and S100B protein returned to the same level as that in pre-anesthesia condition（ P〉 0. 05）. Meanwhile,after postoperative 4 and 24 hours,compared with pre-anesthesia condition,Mini-Mental State Examination（ MMSE） score obviously declined（ P〈0. 05 or P 〈0. 01）,and the declining rate in propofol group was obviously lower than that in sevoflurane group（ P〈0. 05）. After postoperative 48 hours,the condition of MMSE score returned to the same level as that in pre-anesthesia condition（ P〉 0. 05）. Conclusion Both sevoflurane and propofol have negative effect on cognitive function of gerontal patients,but compared with sevoflurane,the negative effect of propofol is lighter,which is more suitable for gerontal patients,and the effect has close relationship with the reduction of NSE in blood serum and S100B protein.

关 键 词：异丙酚 七氟醚 老年 认知功能 神经元特异性烯醇化酶 S100B蛋白 

分 类 号：R614[医药卫生—麻醉学]