CAJ | 학술논문

目的：研究术后认知功能障碍(postoperative cognitive dysfunction,POCD)与外周血α1-抗糜蛋白酶(α1-antichymotrypsin,α1-ACT)的临床关系。方法随机选择全身麻醉下行普外科手术患者64例,在术前1 d、术后7 d 和术后3月采用成套神经心理测验(battery of cognitive assess-ment instruments,BCAI)评价患者认知功能,根据结果分为 POCD 和非 POCD。所有患者随机分为乌司他丁组(U 组,n=30,于麻醉诱导前30 min 将10000 U/kg 乌司他丁溶于100 ml 生理盐水中,20 min 内静滴完毕)和对照组(C 组,n=34,给予等容量生理盐水)。在术前1 d、术后7 d 和术后3月分别采血检测α1-ACT。结果术后7 d、术后3月两组 POCD 患者α1-ACT 的表达明显高于非 POCD患者(P <0.05)。术后7 d 所有患者α1-ACT 的表达均明显高于术前1 d(P <0.05)。术前1 d POCD 与非 POCD 患者α1-ACT 表达差异无统计学意义。U 组术后7 d、术后3月 POCD 的发生率明显低于 C 组(P <0.05)。结论 POCD 的发生与血浆中α1-ACT 的表达增高有关。
목적：연구술후인지공능장애(postoperative cognitive dysfunction,POCD)여외주혈α1-항미단백매(α1-antichymotrypsin,α1-ACT)적림상관계。방법수궤선택전신마취하행보외과수술환자64례,재술전1 d、술후7 d 화술후3월채용성투신경심리측험(battery of cognitive assess-ment instruments,BCAI)평개환자인지공능,근거결과분위 POCD 화비 POCD。소유환자수궤분위오사타정조(U 조,n=30,우마취유도전30 min 장10000 U/kg 오사타정용우100 ml 생리염수중,20 min 내정적완필)화대조조(C 조,n=34,급여등용량생리염수)。재술전1 d、술후7 d 화술후3월분별채혈검측α1-ACT。결과술후7 d、술후3월량조 POCD 환자α1-ACT 적표체명현고우비 POCD환자(P <0.05)。술후7 d 소유환자α1-ACT 적표체균명현고우술전1 d(P <0.05)。술전1 d POCD 여비 POCD 환자α1-ACT 표체차이무통계학의의。U 조술후7 d、술후3월 POCD 적발생솔명현저우 C 조(P <0.05)。결론 POCD 적발생여혈장중α1-ACT 적표체증고유관。
Objective To investigate the relationship between the expression ofα1-antichymot-rypsin (α1-ACT)in plasma and postoperative cognitive dysfunction(POCD).Methods The cognitive function of 64 patients undergoing operation under general anesthesia was evaluated by a battery of cognitive assessment instruments(BCAI)and the levels ofα1-ACT were measured at the time 1 d pre-operatively and 7 d and 3 months postoperatively.The patients were randomly divided into two groups:30 patients in ulinastatin group (group U)were injected with 10 000 U/kg ulinastatin,which was dissolved in 100 ml saline,within 20 min at the time of 30 minutes before induction;while control group (group C)were injected with the same volume saline.Results There was no significant differ-ence between the expression of α1-antichymotrypsin in patients with POCD and in control patients at the time before operation.Compared with control patients,the levels of α1-ACT in patients with POCD at the time of 7 d and 3 months postoperation were significantly higher (P <0.05).The levels of α1-ACT at 7 d postoperation were significantly higher than that preoperatively in both groups (P <0.05).The incidence of POCD in group U were significantly lower than that in group C,at the time of 7 d and 3 months after surgery (P <0.05).Conclusion POCD is associated with high expression of plasma α1-ACT.