帕瑞昔布钠对老年患者胃癌术后早期认知功能的影响  

Effects of parecoxib sodium on postoperative cognitive function in elderly patients undergoing gastrointestinal surgery

作　　者：吴运香[1] 魏昕[1] 章敏[1] 马骏[1] 谢黄瑞 柴小青[1] 

机构地区：[1]安徽省立医院麻醉科,合肥市230001

出　　处：《临床麻醉学杂志》2015年第4期320-322,共3页Journal of Clinical Anesthesiology

基　　金：国家自然科学基金青年基金(81300970)

摘　　要：目的 评价帕瑞昔布钠对老年患者胃癌根治术后早期认知功能的影响.方法 择期行胃癌根治术的患者45例,年龄60～75岁,ASAⅠ或Ⅱ级,随机分为对照组（C组）、40 mg帕瑞昔布钠组（P1组）和80 mg帕瑞昔布钠组（P2组）,每组15例.C组、P1组分别于手术前30 min静脉注射生理盐水和帕瑞昔布钠40 mg,P2组在给药90 min后再次静注帕瑞昔布钠40 mg.局麻下行右颈内静脉逆行穿刺置管至颈内静脉球部,分别采集诱导前（T0）、首次给药后2 h（T1）、6 h（T2）及术后24 h（T3）血标本,采用ELISA法测定血清中IL-6、TNF-α及Aβ含量.记录麻醉前24 h及术后24 h和48 h简易精神状态量表（MMSE）评分,对患者的认知功能进行评定.结果 与C组比较,T2、T3时P1组和P2组IL-6、TNF-α及Aβ含量明显降低（P＜0.05）,术后24 h和48 h MMSE评分明显升高（P＜0.05）.P1组与P2组MMSE评分差异无统计学意义.结论 帕瑞昔布钠可降低老年患者胃癌术后早期认知功能障碍的发生,其机制可能与抑制脑内炎性因子及Aβ蛋白表达有关.Objective To investigate the effects of parecoxib sodium on postoperative cognitive function in elderly patients undergoing gastrointestinal surgery. Methods Forty-five patients, aged 60-75 yr, for gastrointestinal surgery, were randomly divided into 3 groups： control group （group C）, 40 mg parecoxib sodium group （group P1） and 80 mg parecoxib sodium group （group P2）. Group C were given normal saline, groups P1 and P2 were given parecoxib sodium 40 mg 30 min in travenously before surgery. Then only in group P2 parecoxib sodium 40 mg injected 90 min after the first given. Then blood samples taken from the right jugular bulb for IL-6, TNF-a and A of plasma concentration determination by ELISA at 30 min before surgery （T0）, 2 h （T1） and 6 h （T2） after the first given and 24 h （T3） after the surgery. Cognitive function was assessed by Mini-Mental State Examination（MMSE） at 24 h before anesthesia and 24 h and 48 h after surgery. Results Compared with group C, plasma concentrations of IL-6, TNF-a and AI in groups P1 and P2 were lower significantly （P〈0. 05） ; MMSE scores in groups P1 and P2 at 24 h and 48 h were significantly increased, but there was no significant difference between groups P1 and P2. Conclusion Parecoxib sodium given before surgery could inhibit the perioperative cytokine responses within cerebral blood vessel in elderly patients undergoing gastrointestinal surgery and decrease the development of postoperative cognitive function.

关 键 词：环氧化酶抑制药 炎性反应 细胞因子 老年 认知功能 

分 类 号：R614[医药卫生—麻醉学] R735.2[医药卫生—外科学]