七氟醚麻醉对老年择期手术患者认知功能及血清脑源性神经营养因子、抗炎性细胞因子的影响  

Influences of sevoflurane anesthesia on cognitive function, serum brain-derived neurotrophic factor and antiinflammatory cytokines in elderly patients with elective surgical procedures

作　　者：贺桂文[1] 汪建[1] 

机构地区：[1]黄石市中心医院麻醉科,湖北黄石435000

出　　处：《临床药物治疗杂志》2017年第5期43-47,共5页Clinical Medication Journal

摘　　要：目的:探讨七氟醚麻醉对老年择期手术患者认知功能及血清脑源性神经营养因子(BDNF)、抗炎性细胞因子白介素-10(IL-10)的影响。方法:选取老年择期手术患者120例,随机分为丙泊酚组和七氟醚组,每组60例,丙泊酚组给予丙泊酚麻醉,七氟醚组给予七氟醚麻醉,统计分析所有患者麻醉前(T0)、插管3min后(T1)、插管5min后(T2)、插管10 min后(T3)、缝合时(T4)的心率(HR)、平均动脉压(MAP)、颈内静脉球部血氧含量(Da-jvO_2)、脑氧代谢率(CMRO_2)、血清BDNF、IL-10水平及术前、术后1、4、7 d的认知功能、不良反应情况。结果:在T1、T2、T3、T4时刻,七氟醚组和丙泊酚组HR、MAP水平基本相同(P>0.05),但前者Da-jvO_2、血清BDNF、IL-10水平明显高于后者,前者CMRO_2水平明显低于后者(P<0.05);七氟醚组术后1、4、7d的简易精神状态检查表得分明显高于丙泊酚组,前者认知功能障碍发生率低于后者(P<0.05),且均无不良反应发生。结论:与丙泊酚比较,七氟醚麻醉可减少老年患者术后认知功能障碍的发生,其可能与改善脑氧供,调节BDNF、IL-10水平有关。Objective： To explore the influence of sevoflurane anesthesia on the cognitive function, serum brain-derived neurotrophic factor （BDNF）, and anti-inflammatory cytokines interleukin 10 （IL-10） in elderly patients with elective surgical procedures. Methods： One hundred and twenty elderly patients receiving elective surgical procedures were enrolled into this study in our Hospitals. The patients were randomly divided into propofol group and evoflurane group, 60 cases in each group. The heart rate （HR）, mean arterial pressure （MAP）, ministry of internal jugular vein ball （Da-jvO2）, blood oxygen content and cerebral oxygen metabolism （CMRO2）, BDNF, and IL-10 levels at anesthesia （T0）, 3 min after intubation （T1）, 5 rain after intubation （T2）, 10 min after intubation （T3）, suture （T4） were measured.The cognitive functions at preoperative and postoperative 1, 4, 7 d, and adverse reactions were assessed and statistical analyzed. Results：At TI, T2, T3, T4 moment, the HR and MAP levels of the propofol group and sevofturane group were the same （P〉0.05）, however, the Da-jvO2 ,serum BDNF, IL-10 levels of the former were higher than those of the latter, while the CMRO2 level of the former were lower than that of the latter（P〈0.05）. The MMSE scores at postoperative 6, 12, 24 h of sevoflurane group were higher than those of the propofol group. The incidence of cognitive dysfunction rate of the former were significantly lower than that of the latter（P〈0.05）.No adverse reactions were observed. Conclusion： Compared with propofol, sevoflurane anesthesia can reduce the occurrence of postoperative cognitive dysfunction in elderly patients, and its mechanism may be related to improving cerebral oxygen supply and regulating BDNF and IL-10 levels.

关 键 词：七氟醚 老年择期手术 认知功能 脑源性神经营养因子 抗炎性细胞因子 

分 类 号：R971.2[医药卫生—药品]