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| 老年脊柱手术患者血清中H-FABP、B-FABP含量变化与术后认知功能改变的相关性 |
| Relationship between postoperative cognitive dysfunction and serum levels of H-FABP and B-FABP in elderly patients undergoing spinal surgery |
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| DOI：10.12089/jca.2019.04.017 |
| 中文关键词: 脂肪酸结合蛋白 术后认知功能障碍 脊柱手术 |
| 英文关键词: Fatty acid-binding protein Postoperative cognitive dysfunction Spinal operation |
| 基金项目:江西省卫健委科技计划项目（20195112） |
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| 中文摘要: |
目的 分析脊柱手术患者术后血清中心型脂肪酸结合蛋白（H-FABP)、脑型脂肪酸结合蛋白（B-FABP)含量变化及其与术后认知功能改变是否具有相关性。
方法 选择择期行腰椎或颈椎椎间盘突出椎管减压椎间植骨融合术患者78例，男46例，女32例，年龄≥60岁，ASAⅠ—Ⅲ级。所有手术在气管插管全凭静脉麻醉下完成。于术前1 d、术后1、3、5 d简易智力状态检查量表（MMSE）评估患者认知功能，采用ELISA法于术前、术后6 h测定血清中H-FABP含量，于术前、术后24 h测定B-FABP含量。根据是否发生POCD分为POCD组和NPOCD组。
结果 术后5 d内POCD的总发生率为25.6%，其中1 d的发生率为19.2%，3 d的发生率为17.9%，5 d的发生率为16.7%。POCD组的年龄明显大于NPOCD组；与NPOCD组比较，POCD组术后血清中H-FABP、B-FABP的含量明显升高。
结论 老年脊柱手术患者术后血清中H-FABP、B-FABP含量升高的幅度与术后POCD的发生率呈正相关。 |
| 英文摘要: |
Objective To investigate the changes of serum levels of H-FABP and B-FABP after surgery in elderly patients undergoing spinal operation and the relationship between serum H-FABP and B-FABP and the incidence of postoperative cognitive dysfunction(POCD).
Methods A total of 78 elderly patients, aged ≥ 60 years, falling into ASA physical status Ⅰ-Ⅲ. undergoing spinal surgery were assigned to the study. All the surgery were undergone total intravenous anesthesia （TIVA）. Mini-mental State Examination (MMSE) scores were evaluated at 1d before surgery, on the 1, 3 and 5 day after surgery. The serum levels of heart fatty acid binding protein (H-FABP) and brain fatty acid binding protein (B-FABP) were detected before and 24 h after surgery with enzyme-linked immuno sorbent assay (ELISA).
Results The overall incidence of POCD was 25.6% within 5 days after surgery . The incidences of POCD occured on the 1st day, 3rd day and 5th day postoperation were 19.2%, 17.9% and 16.7% respectively. The age of the patients with POCD was significantly older than those with no POCD(P<0.05). Compared with the patients with no POCD, the serum levels of H-FABP at 6h and B-FABP at 24 h postsurgery in those with POCD increased more significantly(P<0.05).
Conclusion The increased serum levels of H-FABP and B-FABP are positively correlated with the incidence of POCD in elder patients undergoing spinal surgery. |
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