Zheng X U, Ma Zhengliang, Gu Xiaoping
Department of Anesthesiology, Drum Tower Hospital, Medical Department of Nanjing University, Nanjing, Jiangsu 210008, P.R. China.
Exp Ther Med. 2015 Apr;9(4):1443-1447. doi: 10.3892/etm.2015.2241. Epub 2015 Jan 30.
The aim of the present study was to evaluate whether the levels of the plasma biomarkers, cortisol, interleukin (IL)-1β, IL-6, IL-10 and tumor necrosis factor (TNF)-α, change in adolescent idiopathic scoliosis patients with postoperative cognitive dysfunction (POCD); thus, may serve as predictive factors for POCD. In total, 75 adolescent scoliosis patients, aged between 11 and 18 years and categorized as American Society of Anesthesiologists classification I or II, were scheduled for orthopedic surgery with general anesthesia. Blood samples were collected on the day of admission and at day 2 following surgery. The plasma levels of IL-1β, IL-6, IL-10 and TNF-α were measured using an enzyme-linked immunosorbent assay, while the concentrations of cortisol were determined using a radioimmunoassay. Cognitive function was assessed one day prior to and at day 7 following the surgery in a quiet room with the guidance of a Chinese version protocol. In total, 66 patients completed the sample collection and neurocognitive tests. According to the criteria for the diagnosis of POCD, 19 patients (28.8%) developed POCD within seven days of surgery. No statistically significant differences were observed in the baseline concentrations of cortisol, TNF-α, IL-1β, IL-10 or IL-6 between the POCD and non-POCD groups. However, the baseline plasma level of TNF-α on day 2 in the POCD group was found to be higher compared with the non-POCD group. In addition, at day 2 after surgery, the concentration of cortisol in the non-POCD group was higher compared with the POCD group. Therefore, the plasma level of TNF-α in adolescent idiopathic scoliosis patients at day 2 following orthopedic surgery may be a predictor for the incidence of early POCD.
本研究的目的是评估血浆生物标志物皮质醇、白细胞介素（IL）-1β、IL-6、IL-10和肿瘤坏死因子（TNF）-α的水平在患有术后认知功能障碍（POCD）的青少年特发性脊柱侧凸患者中是否发生变化；因此，其可能作为POCD的预测因素。总共75例年龄在11至18岁之间、美国麻醉医师协会分级为I或II级的青少年脊柱侧凸患者计划接受全身麻醉的骨科手术。在入院当天和术后第2天采集血样。使用酶联免疫吸附测定法测量IL-1β、IL-6、IL-10和TNF-α的血浆水平，而使用放射免疫测定法测定皮质醇的浓度。在安静的房间里，按照中文版方案的指导，在手术前一天和术后第7天评估认知功能。总共66例患者完成了样本采集和神经认知测试。根据POCD的诊断标准，19例患者（28.8%）在术后7天内发生了POCD。POCD组和非POCD组之间在皮质醇、TNF-α、IL-1β、IL-10或IL-6的基线浓度方面未观察到统计学上的显著差异。然而，发现POCD组术后第2天的TNF-α基线血浆水平高于非POCD组。此外，术后第2天，非POCD组的皮质醇浓度高于POCD组。因此，青少年特发性脊柱侧凸患者骨科手术后第2天的TNF-α血浆水平可能是早期POCD发生率的一个预测指标。
