摘要
目的探讨丙泊酚对前列腺手术老年患者血清神经生长因子(NGF)、神经元特异性烯醇化酶(NSE)、S100β蛋白的影响及其意义。方法选取2014年2月至2017年4月治疗的80例行前列腺手术老年患者采用前瞻性研究设计,随机分为对照组和试验组各40例。实验组注输丙泊酚,对照组注输异氟醚。两组患者分别于手术前、手术后6h、24 h、72 h采静脉血检测血清NGF、NSE及S100β的浓度做对比分析。采用简易智能状态检查量表(MMSE)评价认知功能。结果治疗前两组患者各参数比较无显著性差异(P>0.05)。两组患者手术后6 h、24 h血清NGF的浓度较术前明显下降,NSE的浓度、S100β蛋白水平较术前明显上升(P<0.05)。手术后72 h两组患者血清NGF、NSE、S100β蛋白的各项指标均恢复到治疗前水平(P>0.05)。术后6 h和术后24 h实验组患者MMSE评分较对照组明显提高,差异有统计学意义(P<0.05)。结论两种麻醉方法均可导致老年前列腺手术患者手术后出现认知功能障碍,这可能与麻醉过程中NGF下降、NSE和神经元特异性烯醇化酶升高有关系,但对于老年前列腺手术患者来说丙泊酚出现的认知功能障碍更小,可能与丙泊酚能够降低血清NSE水平有关。
Objective To investigate the effect of propofol on serum NGF（ nerve growth factor）,NSE（ neuron specific enolase） and S100 beta protein in elderly patients undergoing prostatectomy. Methods From February 2014 to April 2017,80 cases of elderly prostate patients treated in our hospital were randomly divided into control group and test group,40 cases in each group. The experimental group was injected with propofol,and the control group was injected with isoflurane. The concentrations of serum NGF,NSE and S100 beta were compared between the two groups before the operation,6 hours,24 hours and 72 hours after the operation. Evaluation of cognitive function by simple intelligent state Checklist（ MMSE）. Results There was no significant difference in parameters between the two groups before treatment（ P〉0. 05）. The level of serum NGF in both groups decreased significantly at 6 hours and 24 hours after operation compared with that before operation. The level of S100β protein in NSE was significantly higher than that before operation（ P〈0. 05）. At 72 hours after operation,the indexes of serum NGFN NSES100 β protein in both groups recovered to the pre-treatment level（ P〉0. 05）. The MMSE scores in the experimental group were significantly higher than those in the control group at 6 hours and 24 hours after operation（ P〈0. 05）. Conclusion Two kinds of methods can lead to cognitive dysfunction in elderly patients with prostate surgery after surgery,and the decrease of NGF,NSE and neuron specific enolase increased,for elderly prostate surgery patients propofol effect is smaller,it has an important significance for reducing serum NSE.
作者
赵琼
许大帅
ZHAO Qiong;XU Da - shuai(Department of Anesthesiology,General Hospital of Jinan Military Command,Jinan Shandong 250031,China;Department of Health Care,Jinan Central Hospital,Jinan Shandong 250031,China.)
出处
《临床和实验医学杂志》
2018年第16期1780-1783,共4页
Journal of Clinical and Experimental Medicine
