咪达唑仑对不同年龄行PCI患者术后认知功能的影响  

Influenceof midazolam on postoperative cognitive function for patients with PCI at different age

作　　者：梁秋霞[1] 

机构地区：[1]洛阳正骨医院,河南洛阳471000

出　　处：《现代医学》2015年第9期1147-1150,共4页Modern Medical Journal

摘　　要：目的：探讨咪达唑仑对不同年龄行经皮冠状动脉成形术（PCI）的患者术后认知功能的影响。方法：选择60例ASAⅠ~Ⅱ级的实施PCI手术患者,按照年龄分为青年组（45~64岁）和老年组（≥65岁）。两组患者均采用咪达唑仑作为麻醉用药,且其他麻醉诱导完全相同。PCI术前、术后采用简易精神状态评价量表（MMSE）测两组患者认知功能,测定血清S100β蛋白及ET-1浓度。结果：PCI术后5~7 d时认知功能障碍发生率青年组为16.7%,老年组为46.6%,两组差异有统计学意义（χ2=8.734,P〈0.01）;两组患者PCI术后S100β蛋白、ET-1浓度均较术前增加,差异有统计学意义（P〈0.05）;术后S100β蛋白老年组明显高于青年组（P〈0.05）。Logistic多因素回归分析结果表明,术后5~7 d及3个月认知功能障碍的风险因素有MMSE值、S100β蛋白及ET-1浓度。结论：咪达唑仑造成老年患者发生术后认知功能障碍的危险性较大。Objective： To evaluate the influence of midazolam on postoperative cognitive function for patients with PCI at different age. Methods： Sixty elder patients with ASA Ⅰ-Ⅱ were randomly divided into two groups： young group（ 45-64 year-old） and old group（ ≥65 year-old）. The two groups were given midazolam as narcotic,other anesthesia induction was the same. The cognitive dysfunction,serum S100β protein and ET-1 levels were detected before and after the surgery. Result： At 5-7 days after surgery,16. 7% in young group and 46. 6% in old group experienced post operation cognitive dysfunction（ POCD）. Concentration of S100β protein and ET-1 in two groups were increased,and the difference was significant（ P 〈 0. 05）. The concentration of S100β protein in old group was significantly higher than that in young group（ P 〈 0. 05）. Result of Logistic multiple regression analysis showed that the risk factors of cognitive impairment were MMSE score,concentrations of S100β protein and ET-1 protein after 5-7 d and 3 months of operation. Conclusion： The risk of POCD caused by midazolam in elderly patients is greater than the young.

关 键 词：咪达唑仑 年龄 术后认知功能 

分 类 号：R614.2[医药卫生—麻醉学]