依达拉奉对髋关节置换术老年患者远期认知功能的影响  

Effect of edaravone on long-term cognitive function in elderly patients undergoing hip replacement

作　　者：谢海辉[1] 张曙[1] 黎建文 韩琪 陈惠群 苏柏勤 陈冬凤 Xie Haihui;Zhang Shu;Li Jianwen;Han Qi;Chen Huiqun;Su Boqin;Chen Dongfeng(Department of Anesthesiology,Affiliated Dongguan People′s Hospital of Southern Medical University,Dongguan 523000,China;Department of Orthopaedics,Affiliated Dongguan People′s Hospital of Southern Medical University,Dongguan 523000,China)

机构地区：[1]南方医科大学附属东莞人民医院麻醉科,523000 [2]南方医科大学附属东莞人民医院骨科,523000

出　　处：《中华麻醉学杂志》2020年第6期651-654,共4页Chinese Journal of Anesthesiology

基　　金：广东省医学科学技术研究基金项目(C2018055)。

摘　　要：目的评价依达拉奉对髋关节置换术老年患者远期认知功能的影响。方法选择髋关节置换术患者160例,年龄≥65岁,采用McLeod改良Wichmann-Hill伪随机数发器生成的随机序列分为2组(n=80):依达拉奉组(E组)和对照组(C组)。均采用脊椎-硬膜外麻醉。麻醉平面固定后即刻至30 min,E组静脉输注依达拉奉60 mg(溶于100 ml生理盐水,输注速率200 ml/h)。于麻醉前、术中(切皮后30 min)、术后1、3和7 d时采用ELISA法检测血清趋化因子配体13(CXCL13)和IL-6浓度。于术后1、2、3和7 d行中文版意识模糊评估量表检测,并记录术后7 d内谵妄发生情况;于术后1个月和12个月时采用认知功能电话问卷修订版(TICS-M)和ADL评分分别评估认知功能和日常生活质量,记录术后认知功能障碍的发生情况。结果与C组比较,E组TICS-M总评分及ADL评分升高,术后谵妄和术后认知功能障碍发生率降低,术中及术后各时点血清CXCL13和IL-6浓度降低(P<0.05)。结论依达拉奉可减轻炎症反应,改善髋关节置换术老年患者远期认知功能。Objective To evaluate the effect of edaravone on long-term cognitive function in elderly patients undergoing hip replacement.Methods A total of 160 patients,aged≥65 yr,undergoing elective hip replacement,were divided into 2 groups(n=80 each)using the random sequence generated by the McLeod-modified Wichmann-Hill pseudo-random number generator:edaravone group(group E)and control group(group C).Spinal-epidural anesthesia was applied in two groups.Edaravone 60 mg(in 100 ml of normal saline,infusion rate 200 ml/h)was intravenously infused from the time point immediately after achieving the anesthesia plane until the following 30 min.Serum chemokine ligand 13(CXCL13)and interleukin-6(IL-6)concentrations were detected by enzyme-linked immunosorbent assay before anesthesia,during surgery(30 min after skin incision),and at postoperative days 1,3 and 7.The Confusion Assessment Method Scale in Chinese was used to detect the postoperative delirium at postoperative days 1,2,3 and 7,and the Telephone Interview for Cognitive Status-Modified and ADL score were adopted to assess the cognitive function and quality of daily living,respectively,and the occurrence of cognitive impairment was recorded at 1 and 12 months after surgery.Results Compared with group C,the total Telephone Interview for Cognitive Status-Modified score and ADL score were significantly increased,the incidence of postoperative delirium and cognitive impairment was decreased,and the serum CXCL13 and IL-6 concentrations were decreased during surgery and at each time point after surgery in group E(P<0.05).Conclusion Edaravone can reduce inflammatory responses and improve long-term cognitive function in elderly patients undergoing hip replacement.

关 键 词：自由基清除剂 认知功能障碍 老年人 

分 类 号：R614[医药卫生—麻醉学]