CAJ | 학술논문

目的：探讨乌司他丁对行经尿道前列腺电气化术（ TUPV）的良性前列腺增生（ BPH）患者认知功能的影响及其可能机制。方法选取2011年7月—2013年10月于赣州市于都县人民医院泌尿外科住院的年龄≥60岁的BPH患者240例，根据随机数字表法将其分为乌司他丁组及对照组各120例。乌司他丁组手术麻醉前使用乌司他丁注射液20万U，术后连续使用3 d，10万U/d。对照组在同一时间使用等量0.9%氯化钠溶液。术前1 d及术后3 d通过蒙特利尔认知评估量表（ MoCA）对患者认知功能进行检测，同时于术前、术毕及术后1、3 d采集患者外周血检测β淀粉样蛋白及Tau蛋白水平。结果术后3 d乌司他丁组MoCA评分总分及视空间/执行能力、注意及延迟记忆评分与对照组比较，差异均有统计学意义（ P<0.05）。两组β淀粉样蛋白及Tau蛋白水平比较，差异有统计学意义（ F交互=75.95、210.00，P<0.05）。术毕、术后1 d两组β淀粉样蛋白及Tau蛋白水平间差异有统计学意义，术后3 d两组Tau蛋白水平间差异有统计学意义（ P<0.05）。两组术毕、术后1 d、术后3 d与术前，术后1 d与术毕，术后3 d与术后1 d β淀粉样蛋白水平间差异有统计学意义（ P<0.05）；对照组术毕、术后1 d、术后3 d与术前，术后1 d、术后3 d与术毕，术后3 d与术后1 d Tau蛋白水平间差异有统计学意义（ P<0.05）；乌司他丁组术毕、术后1 d与术前，术后1 d与术毕，术后3 d与术后1 d Tau蛋白水平间差异有统计学意义。结论乌司他丁对行TUPV的BPH患者的认知功能具有保护作用，可能与其降低β淀粉样蛋白及Tau蛋白水平有关。
목적：탐토오사타정대행경뇨도전렬선전기화술（ TUPV）적량성전렬선증생（ BPH）환자인지공능적영향급기가능궤제。방법선취2011년7월—2013년10월우공주시우도현인민의원비뇨외과주원적년령≥60세적BPH환자240례，근거수궤수자표법장기분위오사타정조급대조조각120례。오사타정조수술마취전사용오사타정주사액20만U，술후련속사용3 d，10만U/d。대조조재동일시간사용등량0.9%록화납용액。술전1 d급술후3 d통과몽특리이인지평고량표（ MoCA）대환자인지공능진행검측，동시우술전、술필급술후1、3 d채집환자외주혈검측β정분양단백급Tau단백수평。결과술후3 d오사타정조MoCA평분총분급시공간/집행능력、주의급연지기억평분여대조조비교，차이균유통계학의의（ P<0.05）。량조β정분양단백급Tau단백수평비교，차이유통계학의의（ F교호=75.95、210.00，P<0.05）。술필、술후1 d량조β정분양단백급Tau단백수평간차이유통계학의의，술후3 d량조Tau단백수평간차이유통계학의의（ P<0.05）。량조술필、술후1 d、술후3 d여술전，술후1 d여술필，술후3 d여술후1 d β정분양단백수평간차이유통계학의의（ P<0.05）；대조조술필、술후1 d、술후3 d여술전，술후1 d、술후3 d여술필，술후3 d여술후1 d Tau단백수평간차이유통계학의의（ P<0.05）；오사타정조술필、술후1 d여술전，술후1 d여술필，술후3 d여술후1 d Tau단백수평간차이유통계학의의。결론오사타정대행TUPV적BPH환자적인지공능구유보호작용，가능여기강저β정분양단백급Tau단백수평유관。
Objective To evaluate the effect of ulinastatin on cognition function of benign prostatic hyperplasia (BPH)patients who had had transurethral prostatic vaporization(TUPV)and its possible mechanism. Methods From July 2011 to October 2013,in Yudu County People's Hospital,240 BPH patients aged≥60 years were enrolled in this study and di-vided randomly into groups study and control,120 in each. The study group were injected with 200 000 U ulinastatin injection before anesthesia of operation,and 100 000 U/d after operation,3 d. The control group given the same amount of 0. 9% sodium chloride solution at the same time. The patients' cognition function was evaluated with Montreal cognitive assessment( MoCA)in 1 d before and 3 d after operation,the levels of beta-Amyloid protein and Tau protein were determined before operation,at the end of operation,1 d and 3 d after operation. Results There was significant difference in MoCA total score,the scores of visu-al-space/implementation capacity,attention and delayed memory of 3 d after operation between the two groups(P<0. 05). There was significant difference in beta -Amyloid protein,Tau protein between the two groups( F =75. 95,210. 00,P <0. 05). There was difference in beta-Amyloid protein,Tau protein between the two groups at the end of operation,1 d after operation,and in Tau protein 3 d after operation(P<0. 05). The levels of beta-Amyloid protein at the end of operation,1, 3 d after opreation were different from those of before operation,those of 1 d after operation from those of at the end of operation, those of 3 d after operation from those of 1 d after operation in the two groups(P<0. 05). The levels of Tau protein at the end of operation,1,3 d after operation differed from those of before operation,those of 1,3 d after operation from those of at the end of operation,those of 3 d after operation from those of 1 d after operation in the control group(P<0. 05). The levels of Tau protein at the end of operation,1 d after operation were different from those of before operation,those of 1 d after operation from those of at the end of operation,those of 3 d after operation from those of 1 d after operation in the study group. Conclusion Ulinastatin,which can protect the cognition function of the BPH patients having had TUPV,may be associated with the reduction of the levels of beta-Amyloid protein and Tau protein.