摘要
目的探讨乌司他丁对老年患者开腹手术后认知功能的影响。方法择期全麻复合硬膜外麻醉下行腹部手术患者40例(65～80岁)均分为两组。U组于麻醉诱导前20min内滴注给予乌司他丁20万U,术中以10万U/h的速度泵入直至手术结束;C组给予等量生理盐水作为对照。于麻醉前、手术2h、术后24h分取静脉血测定白细胞介素(IL)-1β、IL-6和肿瘤坏死因子(TNF)α。分别于术前1d和术后3d用韦氏成人记忆量表和智力量表对患者进行神经精神功能测试。结果手术2h和术后24h两组患者IL-1β、IL-6、TNF-α较麻醉前均明显升高(P<0.05,P<0.01),手术2hU组IL-6、TNF-α显著低于C组(P<0.01,P<0.05);U组在数字广度(逆向)测试成绩明显高于C组(P<0.05)。结论乌司他丁可以减少老年开腹术患者术后早期认知障碍的发生,可能与抑制促炎细胞因子TNF-α和IL-6的释放有关。
Objective To investigate the effects of ulinastatin on cognitive function of the elderly patients underwent abdominal surgery. Methods Fourty patients, aged 65 to 80 years old, undergoing selective abdominal operation under combined general and epidural anesthesia （CGEA） were randomly divided into two groups with 20 cases each. Group U was given ulinastatin 200 000 U infused in 20 min before anesthesia induction, which was followed by 100 000 U/h infusion until the end of operation. Group C was given equal volume normal saline as the control Plasma concentrations of interleukin（IL）-1,IL-6 and tumor necrosis factor（TNF）-α were detected before anaesthesia,at 2 h during and 24 h after operation. A battery of neuropsychological tests was performed with Wechsler Adult Intelligence Scale-Revised and Wechsler Memory Scale （WMS） one day before and on the 3rd day after operation. Results Plasma concentrations of IL-1β, IL-6 and TNF-α in both groups were higher at 2 h during and 24 h after operation than those before （P〈0.05 and P〈0.01） ,which of IL-6 and TNF-α at 2 h during operation were lower in group U than those in group C （P〈 0.01, P〈 0. 05）. The neuropsychological scopes were significantly higher in group U than those in group C （P〈 0. 05）. Conclusion Ulinastatin can effectively attenuate cognitive dysfunction in the elderly patients underwent abdominal surgery under CGEA, possibly related to inhibitory effect of ulinastatin on the liberation of proinflammatory cytokines.
出处
《江苏医药》
CAS
CSCD
北大核心
2010年第20期2403-2405,共3页
Jiangsu Medical Journal
关键词
乌司他丁
认知功能
老年
Ulinastatin
Cognitive function
Geriatrics
