摘要
目的探讨外周血促炎蛋白S100钙离子结合蛋白A9(S100A9)水平与老年宫颈癌患者术后认知功能障碍(POCD)发生的关系。方法前瞻性队列研究分析2018年7月至2020年6月于福建省肿瘤医院接受全麻下宫颈癌根治术的80例老年宫颈癌患者临床相关资料。采集全部患者术前1 d、术后1 d、术后7 d时外周静脉血并测定S100A9和炎性因子白介素-6(IL-6)水平,根据术后是否发生POCD将其分为POCD组与非POCD组,对比两组术前及术后外周血S100A9及IL-6水平。结果80例老年患者术后发生POCD共19例(POCD组),未发生POCD者共61例(非POCD组),两组年龄、美国麻醉医师协会(ASA)分级等基础资料比较差异无统计学意义(P>0.05)。两组术前S100A9水平比较,差异无统计学意义(P>0.05),术后1 d、术后7 d时非POCD组患者外周血S100A9水平与术前比较,差异无统计学意义(P>0.05),但POCD组患者术后1 d、术后7 d时S100A9水平明显高于术前及非POCD组,差异有统计学意义(P<0.05)。术前两组IL-6水平比较差异无统计学意义(P>0.05),术后均较术前明显升高,但POCD组术后各时相IL-6水平明显高于非POCD组,差异有统计学意义(P<0.05)。结论老年宫颈癌患者全麻根治术后POCD的发生和外周血S100A9水平的升高很可能密切相关,临床可据此对POCD开展针对性预防与管理措施,降低老年宫颈癌患者术后POCD发生风险。
Objective To investigate the relationship between the levels of proinflammatory protein S100 calcium binding protein A9(S100A9)in peripheral blood and the occurrence of post-operative cognitive dysfunction(POCD)in elderly patients with cervical cancer.Methods A prospective cohort study was conducted to analyze the relevant clinical data of 80 elderly patients with cervical cancer who underwent radical hysterectomy under general anesthesia in Fujian Cancer Hospital from July 2018 to June 2020.Peripheral venous blood was collected and S100A9 and inflammatory factor interleukin-6(IL-6)levels were measured in all patients at 1 d before the operation,1 d and 7 d after the operation.These patients were divided into the POCD group and the non-POCD group based on the presence or absence of POCD after the operation.The S100A9 and IL-6 levels in peripheral blood before and after the operation were compared between the two groups.Results Among 80 elderly patients,there were 19 patients suffered from POCD after the operation(the POCD group)and 61 patients did not suffer from POCD(the non-POCD group).There were no statistically significant differences between the two groups in terms of age,American Society of Anesthesiologists(ASA)classification and other basic data(P>0.05).There was no statistically significant difference between the two groups in preoperative S100A9 levels(P>0.05).Meanwhile,there were no statistically significant differences in peripheral blood S100A9 levels of the patients in the non-POCD group at 1 d and 7 d after the operation compared with those before the operation(P>0.05).However,the S100A9 levels of the patients in the POCD group at 1 d and 7 d after the operation were significantly higher than those before the operation and those in the non-POCD group,with statistically significant differences(P<0.05).There were no statistically significant difference between the two groups in preoperative IL-6 levels(P>0.05),but the postoperative levels in both groups were significantly higher than those before the operation,and the postoperative IL-6 levels in the POCD group were significantly higher than those in the non-POCD group at each time phase,with statistically significant differences(P<0.05).Conclusion The occurrence of POCD after radical hysterectomy under general anesthesia in elderly patients with cervical cancer and the increase of peripheral blood S100A9 levels are likely to be closely related.Therefore,targeted prevention and management measures should be carried out clinically to reduce the risk of postoperative POCD in elderly patients with cervical cancer.
作者
林智平
陈妍
王兰兰
王英
LIN Zhiping;CHEN Yan;WANG Lanlan;WANG Ying(Department of Anesthesiology,the Cancer Affiliated Hospital of Fujian Medical University,Fujian Cancer Hospital,Fujian,Fuzhou 350014,China)
出处
《中国医药科学》
2021年第14期18-21,共4页
China Medicine And Pharmacy
基金
福建省自然科学基金资助项目(2018J01272)。
关键词
外周血S100A9
老年宫颈癌
全麻下宫颈癌根治术
术后认知功能障碍
相关性研究
Peripheral blood S100A9
Elderly patients with cervical cancer
Radical hysterectomy under general anesthesia
Postoperative cognitive dysfunction
Correlation study
