rSO_(2)、S100β、NSE水平与心脏瓣膜置换术后患者发生早期认知功能障碍的相关性  

Correlations among rSO_(2),S100βand NSE levels during cardiac valve replacement and early postoperative POCD

作　　者：李玉彩 郑利娜[1] 李雅丽[1] LI Yucai;ZHENG Lina;LI Yali(Department of Cardiac Surgery of the 7th People’s Hospital of Zhengzhou,Zhengzhou 450000 Henan,China)

机构地区：[1]郑州市第七人民医院心外科,河南郑州450000

出　　处：《中国民康医学》2023年第22期156-158,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:分析局部脑组织氧饱和度(rSO_(2))、S100β蛋白(S100β)、神经元特异性烯醇酶(NSE)水平与心脏瓣膜置换术后患者发生早期认知功能障碍的相关性。方法:回顾性分析2020年7月至2022年4月于该院行心脏瓣膜置换术的104例患者的临床资料。术后1 d,采用简易智能精神状态检查量表(MMSE)评估患者认知功能,根据MMSE评分将其分为认知功能障碍组(n=35)与非认知功能障碍组(n=69)。比较两组插管后5 min、体外循环开始时、结束时rSO_(2)、S100β、NSE水平,并采用Spearman相关性分析术中rSO_(2)、S100β、NSE水平与心脏瓣膜置换术后发生早期认知功能障碍的相关性。结果:插管后5 min、体外循环开始时、结束时,COPD组rSO_(2)水平均低于非认知功能障碍组,差异有统计学意义(P<0.05);插管后5 min,认知功能障碍组S100β水平低于非认知功能障碍组,NSE水平高于对照组,差异有统计学意义(P<0.05);体外循环开始、结束时,两组S100β、NSE水平均高于插管后5 min,且认知功能障碍组高于非认知功能障碍组,体外循环结束时高于体外循环开始时,差异有统计学意义(P<0.05);经Spearman相关性分析结果显示,rSO_(2)水平与心脏瓣膜置换术后发生早期认知功能障碍呈负相关(r<0,P<0.05),S100β、NSE水平与心脏瓣膜置换术后发生早期认知功能障碍呈正相关(r>0,P<0.05)。结论:rSO_(2)水平与心脏瓣膜置换术后发生早期认知功能障碍呈负相关,S100β、NSE水平与心脏瓣膜置换术后发生早期认知功能障碍呈正相关。Objective:To analyze correlations among regional cerebral oxygen saturation(rSO_(2)),central nervous specific protein(S100β),neuron-specific enolase(NSE)levels during cardiac valve replacement and early postoperative cognitive dysfunction(POCD).Methods:The clinical data of 104 patients who underwent cardiac valve replacement in this hospital from July 2020 to April 2022 were retrospectively analyzed.1 day after the surgery,the cognitive function scores of these patients were evaluated by mini-mental state examination(MMSE).According to the MMSE score,they were divided into POCD group(n=35)and non-POCD group(n=69).The levels of rSO_(2),S100βand NSE were compared between the two groups 5 min after intubation,at the beginning and end of cardiopulmonary bypass.Spearman correlation analysis was used to analyze the correlations among the intraoperative rSO_(2),S100β,NSE levels and early postoperative POCD.Results:5 min after intubation,at the beginning and end of cardiopulmonary bypass,the level of rSO_(2) in the COPD group was lower than that in the non-POCD group,and the difference was statistically significant(P<0.05).5 min after intubation,the S100βlevel in the POCD group was lower than that in the non-POCD group,the NSE level was higher than that in the control group,and the differences were statistically significant(P<0.05).At the beginning and end of extracorporeal circulation,the levels of S100βand NSE in the two groups were higher than those 5 min after intubation,and those in the POCD group were higher than those in the non-POCD group,those at the end of extracorporeal circulation were higher than those at the beginning of extracorporeal circulation,and the differences were statistically significant(P<0.05).Spearman correlation analysis showed that the rSO_(2) level was negatively correlated with early POCD after cardiac valve replacement(r<0,P<0.05),and the S100βand NSE levels were positively correlated with early POCD(r>0,P<0.05).Conclusions:The level of rSO_(2) is negatively correlated with the early

关 键 词：心脏瓣膜置换术 认知功能障碍 局部脑组织氧饱和度 神经元特异性烯醇酶 中枢神经特异性蛋白 

分 类 号：R725.7[医药卫生—儿科]