依达拉奉对老年患者围术期炎性反应及术后认知功能障碍的影响  

Effects of edaravone on perioperative inflammatory response and postoperative cognitive function in aged patients

作　　者：姜维[1] 胡远[1] 孙云云[1] 何文胜[1] 

机构地区：[1]合肥市第二人民医院麻醉科,230011

出　　处：《临床麻醉学杂志》2014年第10期961-963,共3页Journal of Clinical Anesthesiology

基　　金：合肥市重点立项课题[合科(2012)121号]

摘　　要：目的观察依达拉奉对老年患者围术期炎性反应及术后认知功能障碍（POCD）的影响。方法择期行髋关节置换术的老年患者48例,年龄65~79岁,ASAⅠ或Ⅱ级,简易精神状态检查量表（MMSE）评分〉24分,随机分为依达拉奉组（E组）和对照组（C组）。E组全麻诱导后静注依达拉奉0.5mg/kg;C组静注等量生理盐水。分别于麻醉诱导后（T1）、手术开始1h（T2）、拔管后1h（T3）和术后24h（T4）抽取静脉血测定血浆TNF-α、IL-6、IL-10水平。术前1d及术后3、5、7d通过MMSE评分对认知功能进行评估,术后MMSE评分较术前减少≥2分则判定为POCD。结果与T1时比较,T2~T4时两组患者TNF-α、IL-6、T3、T4时两组IL-10水平明显升高（P〈0.05）。与术前比较,术后3、5d两组患者MMSE评分明显降低（P〈0.05）。与C组比较,T3、T4时E组患者TNF-α、IL-6水平明显降低（P〈0.05）,术后3、5dE组的MMSE评分明显增高（P〈0.05）。E组术后发生POCD 3例,明显少于C组9例（P〈0.05）。结论依达拉奉可抑制围术期炎性因子的水平,降低POCD的发生。Objective To investigate the effects of edaravone on perioperative inflammatory response and postoperative cognitive function in aged patients.Methods Forty-eight ASA ⅠorⅡelderly patients with MMSE score〉24,aged 65-79 year sold,scheduled for elective hip surgeries were randomly divided into the edaravone group（group E）and the control group（group C）.Group E patients received edaravone 0.5mg/kg and group C received the same volume of saline.The blood samples were reserved after anesthesia induction（T1）,1hafter the beginning of operation（T2）,1hafter extubation（T3）and 24 hafter operation（T4）for detecting the concentrations of TNF-α,IL-6and IL-10.Cognitive function was also evaluated at 3,5 and 7 d after operation using MMSE.Results Compared with the group C,the concentrations of TNF-αand IL-6 were significant decreased at T3 and T4and the MMSE scores were increased at 3dand 5dafter operation in group E（P〈0.05）.Conclusion Edaravone can reduce postoperative inflammatory response and the incidence of early period POCD.

关 键 词：依达拉奉 炎性反应 术后认知功能障碍 

分 类 号：R96[医药卫生—药理学]