椎管内麻醉后CD老年患者S100β、H-FABP、NLRP3mRNA、Caspase-1 mRNA表达意义  

Expression significance of S100β,H⁃FABP,NLRP3 mRNA and caspase⁃1 mRNA in elderly patients with CD after intraspinal anesthesia

作　　者：周洁 胡胜红[2] 李传保 潘孝飞 ZHOU Jie;HU Shenghong;LI Chuanbao;PAN Xiaofei(Department of Anesthesiology,Anhui Susong County People's Hospital,Anqing,Anhui,China,246501;Department of Anesthesiology,Anhui Anqing Municipal Hospital,Anqing,Anhui,China,246004)

机构地区：[1]安徽省宿松县人民医院麻醉科,安徽宿松246501 [2]安徽省安庆市立医院麻醉科,安徽安庆246004

出　　处：《分子诊断与治疗杂志》2024年第4期639-643,共5页Journal of Molecular Diagnostics and Therapy

基　　金：安徽医科大学校科研基金项目(2019xkj235)。

摘　　要：目的分析老年髋关节置换术(THA)患者椎管内麻醉后认知功能障碍(CD)发生的危险因素及中枢神经特异蛋白(S100-β)、核苷酸结合寡聚化域受体蛋白3信使核糖核酸(NLRP3 mRNA)、中心型脂肪酸结合蛋白(H-FABP)、天冬氨酸蛋白水解酶1信使核糖核酸(Caspase-1 mRNA)对其预测价值。方法将椎管内麻醉后发生CD的40例老年THA术患者纳入A组,另选取未发生CD的68例老年THA术患者纳入B组。比较两组临床资料、S100-β、H-FABP、NLRP3 mRNA、Caspase-1 mRNA,危险因素采用多因素Logistic回归分析法进行分析,S100-β、H-FABP、NLRP3 mRNA、Caspase-1 mRNA对老年THA术患者椎管内麻醉后CD发生的预测价值采用受试者工作特征(ROC)曲线进行分析。结果A组年龄大于B组,差异有统计学意义(t=13.674,P<0.05);有糖尿病、术中低血压的患者占比均高于B组,差异有统计学意义(χ^(2)=12.643、17.767,P<0.05)。A组血清S100-β、NLRP3 mRNA、H-FABP、Caspase-1mRNA表达均高于B组,差异有统计学意义(t=14.571、21.691、80.159、23.572,P<0.05)。老年THA术患者椎管内麻醉后CD发生的独立危险因素包括年龄大、糖尿病、术中低血压、血清S100-β、H-FABP、水平、NLRP3 mRNA、Caspase-1 mRNA高,差异有统计学意义(P<0.05)。S100-β、H-FABP、NLRP3 mRNA、Caspase-1 mRNA联合检查预测老年THA术患者椎管内麻醉后CD发生的曲线下面积(AUC)为0.915高于单一检测(P<0.05)。结论年龄大、糖尿病、术中低血压均为老年THA术患者椎管内麻醉后CD发生的独立危险因素,且S100-β、H-FABP、NLRP3 m RNA、Caspase-1 mRNA联合检测对CD的预测价值较高。Objective To analyze the risk factors of cognitive dysfunction(CD)after intraspinal anesthesia in elderly patients with hip arthroplasty(THA)and predictive value of central nerve specific protein(S100⁃β),nucleotide binding oligonucleotide domain receptor protein 3 messenger RNA(NLRP3 mRNA),central fatty acid binding protein(H⁃FABP)and aspartate proteolytic enzyme 1 messenger RNA(caspase⁃1 mRNA).Methods 40 elderly THA patients who developed CD after spinal anesthesia were included in group A,and another 68 elderly THA patients who did not develop CD were selected for group B.The clinical data,S100⁃β,H⁃FABP,NLRP3 mRNA,and caspase⁃1 mRNA of the two groups were compared,and the risk fac⁃tors were analyzed through multifactor logistic regression analysis.The predictive value of S100⁃β,H⁃FABP,NLRP3 mRNA,and caspase⁃1 mRNA on the occurrence of CD after intraspinal anesthesia in elderly patients with hip replacement was analyzed using receiver operating characteristic(ROC)curve.Results The age of group A was significantly longer than that of group B(t=13.674,P<0.05).The proportion of patients with diabetes and in⁃traoperative hypotension was also higher than that in group B(χ^(2)=12.643,17.767,P<0.05).The expression lev⁃els of serum S100⁃β,NLRP3 mRNA,H⁃FABP,and caspase⁃1 mRNA in group A were significantly higher than those in group B(t=14.571,21.691,80.159,23.572,P<0.05).The independent risk factors for CD after spinal anesthesia in elderly patients undergoing THA included older age,diabetes mellitus,intraoperative hyposthenia,and high levels of serum S100⁃β,H⁃FABP,NLRP3 mRNA,and caspase⁃1 mRNA(P<0.05).The combined de⁃tection of S100⁃β,H⁃FABP,NLRP3 mRNA,and caspase⁃1 mRNA predicted an area under the curve(AUC)of 0.915 for CD occurrence after spinal anesthesia in elderly patients undergoing THA surgery,which was higher than with a single detection(P<0.05).Conclusion Old age,diabetes mellitus,and intraoperative hyposthenia were all independent risk factors for CD after int

关 键 词：中枢神经特异蛋白 中心型脂肪酸结合蛋白 核苷酸结合寡聚化域受体蛋白3 天冬氨酸蛋白水解酶 

分 类 号：R614[医药卫生—麻醉学]