摘要
目的分析依托咪酯麻醉对老年腹腔镜手术患者术后神经功能及核因子E2相关因子2(Nrf2)/血红素氧合酶-1(HO-1)信号通路的影响。方法前瞻性选取2023年1月至2025年1月安徽医科大学附属宿州医院(宿州市立医院)收治的106例老年腹腔镜手术患者作为研究对象,按抽签法分为观察组(n=53)、对照组(n=53)。对照组行常规静脉麻醉,观察组行依托咪酯麻醉。比较两组患者认知功能[简易精神状态量表(MMSE)评分、蒙特利尔认知评估(MoCA)评分]、神经功能[中枢神经特异蛋白S100β、神经元特异性烯醇化酶(NSE)]、Nrf2/HO-1信号通路及并发症发生情况。结果两组患者术后1、3、7 d的MMSE评分、MoCA评分均较术前降低,观察组MMSE评分、MoCA评分均高于对照组,差异均有统计学意义(P<0.05)。两组术后6、24 h血清S100β、NSE水平均较术前升高,而观察组血清S100β、NSE水平均低于对照组,差异均有统计学意义(P<0.05)。两组术后6 h的Nrf2、HO-1水平均较术前升高,且观察组Nrf2、HO-1水平均高于对照组,差异均有统计学意义(P<0.05)。观察组并发症总发生率为16.98%,低于对照组(39.62%),差异有统计学意义(P<0.05)。结论依托咪酯麻醉能够平稳老年腹腔镜手术患者术后认知功能及神经功能,且能够激活Nrf2/HO-1信号通路,减少术后并发症。
Objective To assess the effects of etomidate anesthesia on postoperative neurological function and nuclear factor E2-related factor 2(Nrf2)/heme oxygenase-1(HO-1)signaling pathway in elderly patients undergoing laparoscopic surgery.Methods A total of 106 elderly patients undergoing laparoscopic surgery admitted to Anhui Medical University Affiliated Suzhou Hospital(Suzhou Municipal Hospital)from January 2023 to January 2025 were prospectively selected as subjects.They were divided into the observation group(n=53)and the control group(n=53)by drawing lots.The control group received conventional intravenous anesthesia,while the observation group received etomidate anesthesia.The cognitive function[mini-mental state examination(MMSE)score,Montreal cognitive assessment(MoCA)score],neurological function[central nervous specific protein S100β,neuron-specific enolase(NSE)],Nrf2/HO-1 signaling pathway and complications were compared between the two groups.Results The MMSE score and MoCA score of the two groups at 1,3 and 7 days after operation were lower than those before operation,and the MMSE score and MoCA score of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).The levels of serum S100βand NSE in the two groups at 6 and 24 h after operation were higher than those before operation,while the levels of serum S100βand NSE in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The levels of Nrf2 and HO-1 at 6 h after operation in the two groups were higher than those before operation,and the levels of Nrf2 and HO-1 in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was 16.98%,which was lower than that in the control group(39.62%),and the difference was statistically significant(P<0.05).Conclusion Etomidate anesthesia can stabilize postoperative cognitive and neurological function in elderly patients undergoing laparoscopic surgery.It can also activate the Nrf2/HO-1 signaling pathway and reduce postoperative complications.
作者
孟宇
王培
秦怀峰
沈鹏
MENG Yu;WANG Pei;QIN Huaifeng(Department of Anesthesiology,Anhui Medical University Affiliated Suzhou Hospital(Suzhou Municipal Hospital),Suzhou Anhui 234000,China)
出处
《临床和实验医学杂志》
2025年第22期2462-2464,F0003,共4页
Journal of Clinical and Experimental Medicine
基金
安徽省2021年度重点研究与开发计划项目(编号:KJ2021A3181)
2022年度宿州市自筹资金项目(编号:SZZCZJ202235)。
关键词
依托咪酯
麻醉
老年腹腔镜手术
神经功能
核因子E2相关因子2
血红素氧合酶-1
信号通路
Etomidate
Anesthesia
Elderly Laparoscopic Surgery
Neurological Function
Nuclear factor erythroid 2-related factor 2
Heme oxygenase-1
Signaling Pathway
