CAJ | 학술논문

目的：探讨异丙酚全身麻醉对老年患者血清神经元特异性烯醇化酶( NSE)、S100B蛋白及认知功能的影响。方法选择68例择期行手术治疗的老年患者，随机分为七氟醚组和异丙酚组，每组34例。分别使用七氟醚和异丙酚全身麻醉。结果两组术后4、24 h 血清NSE和S100B 蛋白水平均较麻醉前明显上升( P<0．05或P<0．01)，且异丙酚组上升幅度明显低于七氟醚组(P<0．05)。两组术后48 h血清NSE和S100B蛋白水平均恢复到麻醉前水平(P>0．05)；同时两组术后4、24 h简易智能量表(MMSE)评分均较麻醉前明显下降(P<0．05或P<0．01)，且异丙酚组下降幅度明显低于七氟醚组(P<0．05)。两组术后48 h MMSE评分均恢复到麻醉前水平(P>0．05)。结论七氟醚和异丙酚麻醉均可降低老年患者术后早期的认知功能，但异丙酚的影响较少，更适合于老年患者，作用与其能降低患者血清NSE和S100B 蛋白水平密切相关。
목적：탐토이병분전신마취대노년환자혈청신경원특이성희순화매( NSE)、S100B단백급인지공능적영향。방법선택68례택기행수술치료적노년환자，수궤분위칠불미조화이병분조，매조34례。분별사용칠불미화이병분전신마취。결과량조술후4、24 h 혈청NSE화S100B 단백수평균교마취전명현상승( P<0．05혹P<0．01)，차이병분조상승폭도명현저우칠불미조(P<0．05)。량조술후48 h혈청NSE화S100B단백수평균회복도마취전수평(P>0．05)；동시량조술후4、24 h간역지능량표(MMSE)평분균교마취전명현하강(P<0．05혹P<0．01)，차이병분조하강폭도명현저우칠불미조(P<0．05)。량조술후48 h MMSE평분균회복도마취전수평(P>0．05)。결론칠불미화이병분마취균가강저노년환자술후조기적인지공능，단이병분적영향교소，경괄합우노년환자，작용여기능강저환자혈청NSE화S100B 단백수평밀절상관。
Objective To discuss the effect of propofol general anesthesia on neuron-specific enolase ( NSE) in blood serum,S100B protein and cognitive function of gerontal patients. Methods 68 cases of gerontal patients un-derwent elective surgery were divided into sevoflurane group and propofol group at random,34 cases in each group and were given the general anesthesia with sevoflurane and propofol separately. Results After postoperative 4 and 24 hours,compared with pre-anesthesia condition,the NSE in blood serum and S100B protein rose sharply (P<0. 05 or P<0. 01),and the rising rate in propofol group was obviously lower than that in sevoflurane group (P<0. 05). After postoperative 48 hours,the condition of NSE in blood serum and S100B protein returned to the same level as that in pre-anesthesia condition (P>0. 05). Meanwhile,after postoperative 4 and 24 hours,compared with pre-anesthesia con-dition,Mini-Mental State Examination(MMSE) score obviously declined (P <0. 05 or P <0. 01),and the declining rate in propofol group was obviously lower than that in sevoflurane group(P<0. 05). After postoperative 48 hours,the condition of MMSE score returned to the same level as that in pre-anesthesia condition (P>0. 05). Conclusion Both sevoflurane and propofol have negative effect on cognitive function of gerontal patients,but compared with sevoflurane, the negative effect of propofol is lighter,which is more suitable for gerontal patients,and the effect has close relation-ship with the reduction of NSE in blood serum and S100B protein.