麻醉维持期不同丙泊酚用量对老年OPCABG患者术后认知功能及S100β蛋白的影响  

Effect of different dosage of propofol in anesthesia maintenance on cognitive function and S100β protein level in elderly patients with OPCABG

作　　者：邹军[1] 张中军[1] 

机构地区：[1]无锡市第三人民医院麻醉科,江苏无锡214041

出　　处：《实用药物与临床》2017年第2期176-180,共5页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨老年患者行非体外循环冠脉搭桥术(Off pump coronary artery bypass,简称OPCABG)中不同丙泊酚麻醉剂量患者术后认知功能的改变及S100β蛋白水平的变化。方法选取2014年2月至2016年2月于我院就诊拟施行OPCABG的老年冠心病患者134例,根据麻醉维持期TCI持续泵注丙泊酚的剂量随机分为低剂量丙泊酚组[低剂量组,1.4 mg/(kg·h)]和高剂量丙泊酚组[高剂量组,3 mg/(kg·h)],每组67例。分析并比较两组患者术中及术后各项血流动力学指标变化、血清S100β蛋白含量变化以及术后认知功能障碍(POCD)的发生率。结果两组患者手术前后麻醉深度指数比较差异有统计学意义(P<0.05);两组患者平均动脉压(MAP)及心率(HR)术中差异无统计学意义(P>0.05),但高剂量组患者术后心率恢复正常水平时间短;高剂量组患者术后认知功能障碍(POCD)发生率及血清S100β蛋白水平均显著低于低剂量组(P<0.05)。结论老年患者行OPCABG时,较高剂量的丙泊酚麻醉维持可有效降低老年患者POCD的发生率及血清S100β蛋白含量。Objective To explore the changes of cognitive function and the level of S100β protein in elderly patients undergoing off-pump coronary artery bypass grafting（OPCABG） with different doses of propofol.Methods Totally 134 patients receiving OPCABG treatment in our hospital from Febuary,2014 to Febuary,2016 were divided into low-dose propofol group[1.4 mg/（kg·h）]and high dose propofol group[3 mg/（kg·h）],67 cases in each group.The hemodynamic,the incidence of POCD and the level of serum S100β protein between the two groups were compared.Results There was significant difference in NTI between the two groups before and after operation（P〈 0.05）.There was no significant difference in MAP and HR during the operation（P 〉0.05） between the two groups,but the postoperative heart rate recovery time of high-dose group was shorter.The incidence of POCD and the level of serum S100β protein of high-dose group were significantly lower than those of low-dose group（P 〈0.05）.Conclusion High-dose of propofol in anesthesia maintenance can effectively reduce the incidence of POCD and the level of serum S100β in elderly patients with OPCABG.

关 键 词：麻醉维持 丙泊酚 POCD S100Β蛋白 

分 类 号：R614[医药卫生—麻醉学]