体外循环术POCD患者血清GDNF、S100β和Aβ含量检测对病情评估的价值  

The value of serum GDNF,S100β,Aβ content on the severity evaluation of POCD patients underwent cardiopulmonary bypass

作　　者：陈怡霏[1] 段晓霞[2] 张官鹏[2] 彭钢[3] 谢燕斌[1] 陈平[1] 

机构地区：[1]绵阳市中心医院麻醉科,四川绵阳621000 [2]泸州医学院附属医院麻醉科,四川泸州646000 [3]泸州医学院,四川泸州646000

出　　处：《临床和实验医学杂志》2017年第1期47-49,共3页Journal of Clinical and Experimental Medicine

基　　金：四川省卫生厅课题(编号:150077)

摘　　要：目的分析研究体外循环术术后认知功能障碍(POCD)患者血清胶质细胞源性神经营养因子(GDNF)、S100β蛋白(S100β)、β淀粉样蛋白(Aβ)含量检测对病情评估的价值。方法选择2012年9月至2014年7月间接受体外循环术的心脏疾病患者176例作为研究对象,根据术后是否发生POCD分为对照组94例和POCD组82例。检测比较两组患者的血清GDNF、S100β、Aβ、兴奋性氨基酸[谷氨酸(GLU)、天冬氨酸(Asp)、甘氨酸(Gly)]水平。结果POCD组患者的体外循环术后1周血清GDNF(32.15±3.09)ng/ml,低于对照组患者的GDNF(67.92±5.88)ng/ml(P<0.05);POCD组患者的术后1周血清S100β(703.17±67.34)ng/L、Aβ(632.83±49.75)ng/L,均高于对照组患者的S100β(595.62±60.57)ng/L、Aβ(475.25±43.11)ng/L(P<0.05);POCD组患者的术后1周血清GLU(29.73±2.53)mmol/L、Asp(22.16±2.18)mmol/L、Gly(213.53±19.83)mmol/L,均高于对照组患者的GLU(23.61±2.09)mmol/L、Asp(17.32±1.85)mmol/L、Gly(181.62±18.99)mmol/L(P<0.05)。结论体外循环术POCD患者血清GDNF、S100β、Aβ、EAAs水平均可发生明显改变,上述指标有望成为评价病情的有效指标之一。Objective To analyze the value of serum GDNF,S100β,Aβ content on the severity evaluation of POCD patients underwent cardiopulmonary bypass. Methods One hundred and seventy- six cases of heart disease patients between September 2012 to July 2014 underwent cardiopulmonary bypass were choosed as research subjects and divided into control group（ n = 94） and POCD group（ n = 82） patients according to whether the occurrence of POCD. All patients＇ serum glial cell line- derived neurotrophic factor（ GDNF）,S100β protein（ S100β）,β- amyloid（ Aβ）,excitatory amino acids（ EAAs） levels were detected and compared. Resluts POCD group patients＇ serum GDNF level was lower than that of control group patients（ 32. 15 ± 3. 09 ng / ml vs. 67. 92 ± 5. 88 ng / ml） one week after cardiopulmonary bypass（P〈0. 05）. POCD group patients＇ serum S100β and Aβ levels were higher than those of control group patients（ 703. 17 ± 67. 34 ng / L vs. 595. 62 ± 60. 57 ng / L、632. 83 ± 49. 75 ng / L vs. 475. 25 ± 43. 11 ng / L） one week after cardiopulmonary bypass（P〈0. 05）. POCD group patients＇ serum GLU,Asp,Gly levels were higher than those of control group patients（ 29. 73 ± 2. 53 mmol / L vs. 23. 61 ± 2. 09 mmol / L,22. 16 ± 2. 18 mmol / L vs. 17. 32± 1. 85 mmol / L,213. 53 ± 19. 83 mmol / L vs. 181. 62 ± 18. 99 mmol / L） one week after cardiopulmonary bypass（P〈0. 05）. Conclusion POCD patients after cardiopulmonary bypass,serum GDNF,S100β,Aβ,EAAs levels change significantly,and they can be considered as early indicators of POCD and used to assess the severity and guide clinical treatment.

关 键 词：体外循环术 术后认知功能障碍 胶质细胞源性神经营养因子 S100Β蛋白 β淀粉样蛋白 病情评估 

分 类 号：R614[医药卫生—麻醉学]