脑源性神经营养因子和神经元特异性烯醇化酶及SIOOB蛋白与老年髋关节手术患者术后谵妄关系的研究  

Relation among brain-derived neurotrophic factor, neuron specific enolase, SIOOB protein and postoperative delirium in elderly patients with hip joint operation

作　　者：林佳鹤 周国庆[1] 岳云[2] 吴安石[2] 

机构地区：[1]北京市平谷区医院麻醉科,101200 [2]首都医科大学附属北京朝阳医院麻醉科,100020

出　　处：《中国医药》2016年第7期1055-1058,共4页China Medicine

基　　金：国家自然科学基金（81371199）

摘　　要：目的探讨脑源性神经营养因子（BDNF）、神经元特异性烯醇化酶（NSE）及S100B蛋白与老年髋关节手术患者术后谵妄的关系。方法回顾性分析2014年3月至2015年3月于北京市平谷区医院因单侧髋关节骨折行髋关节手术的65岁以上患者共97例，根据是否出现术后谵妄分为谵妄组（20例）和非谵妄组（77例）。采集2组患者术前和术后24h的血清标本，测定并比较2组BDNF、NSE和S100B蛋白浓度。分析血清BDNF、NSE和S100B蛋白浓度与术后谵妄的关系。结果2组患者术后血清BDNF浓度均明显高于术前[非谵妄组：（2031±660）ng／L比（1393±622）ng/L，P〈0．05；谵妄组：（2146±462）ng/L比（1709±674）ng/L，P〈0．05]；且谵妄组患者术前血清BDNF浓度明显高于非谵妄组（P〈0．05）。2组患者血清NSE[术前：（12．1±2．3）μg/L比（12．5±2．7）μg/L；术后：（12．2±2．7）μg/L比（12．0±2．2）μg/L]、S100蛋白[术前：（1235±286）ng/L比（1241±257）ng／L；术后：（1233±273）ng/L比（1179±247）ng／L]浓度及术后血清BDNF浓度差异均无统计学意义（P〉0．05）。二分类Logistic回归分析显示术前血清BDNF浓度升高与术后谵妄的发生有相关性（比值比：3．417，95％置信区间：1．130～10．333，P=0．030）。结论老年髋关节手术患者术前BDNF升高与术后谵妄发生有关。Objective To investigate relation among brain-derived neurotrophic factor （BDNF）, neuron specific enolase （ NSE ） , S100B protein and postoperative delirium in elderly patients with hip joint operation. Methods Totally 97 patients over 65 years old had unilateral hip joint operation from March 2014 to March 2015 in Beijing Pinggu Hospital were retrospectively analyzed and divided into 2 groups according to the occurrence of postoperative delirium ： delirium group （20 cases） and non-delirium group （77 cases ）. Serum levels of BDNF, NSE and S100B protein were measured before and 24 h after operation. Relation among serum BDNF, NSE, S100B protein and postoperative delirium was analyzed. Results Postoperative serum levels of BDNF were significantly higher than those before operation in both groups [ non-delirium group ： （ 2 031 ± 660） ng/L vs （ 1 393 ± 622 ） ng/L, P 〈 0.05 ; delirium group ： （2 146 ± 462） ng/L vs （ 1 709 ± 674） ng/L, P 〈 0. 05 ]. The preoperative serum level of BDNF in delirium group was significantly higher than that in non-delirium group（P 〈 O. 05 ）. Serum levels of NES[preoperative： （ I2. 1 - 2. 3） μg/L vs （ 12. 5 ± 2. 7） μg/L; postoperative： （ 12. 2 ± 2. 7） μg/L vs （ 12.0 ± 2.2） μg/L] , S100B protein [ preoperative ： （ 1 235 ± 286 ） ng/L vs （ 1 241 ± 257 ） ng/L; postoperative ： （1 233-±273） ng/L vs （1 179 ± 247）ng/L] and the postoperative serum level of BDNF had no significant differences between groups （ P 〉 0.05 ）, Binomial logistic regression analysis showed that elevated preoperative BDNF had correlation with postoperative delirium（ Odds Ratio： 3. 417, 95% Confidence Interval： 1. 130-10. 333, P = 0. 030）. Conclusion Elevated preoperative BDNF is correlated with the occurance of postoperative delirium in elderly people with hip joint operation.

关 键 词：谵妄 髋关节手术 脑源性神经营养因子 

分 类 号：R619[医药卫生—外科学]