S100B蛋白和神经元特异性烯醇化酶作为冠状动脉搭桥手术后认知功能障碍的预测指标：一项前瞻性观察研究。
S100B protein and neuron-specific enolase as predictors of cognitive dysfunction after coronary artery bypass graft surgery: A prospective observational study.
作者信息
Silva Fernando P, Schmidt Andre P, Valentin Livia S, Pinto Katia O, Zeferino Suely P, Oses Jean P, Wiener Carolina D, Otsuki Denise A, Tort Adriano B L, Portela Luis V, Souza Diogo O, Auler Jose O C, Carmona Maria J C
机构信息
From the Department of Anaesthesia and Surgical Intensive Care, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo (FPS, LSSV, KOP, SPZ, DAO, JOCA, MJCC); Department of Anaesthesia and Perioperative Medicine, Division of Anaesthesia, Hospital de Clinicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul (UFRGS) (APS); Department of Surgery, Federal University of Health Sciences of Porto Alegre (UFCSPA) (APS); Department of Biochemistry, Institute of Health Sciences (ICBS), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre (APS, LVP, DOS); Laboratório de Neurociências Clinicas, Programa de Pós-graduação em Saúde e Comportamento, Centro de Ciências da Vida e da Saúde e Hospital Universitário São Francisco de Paula, Universidade Católica de Pelotas, Pelotas (JPO, CDW); and Brain Institute, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil (ABLT).
出版信息
Eur J Anaesthesiol. 2016 Sep;33(9):681-9. doi: 10.1097/EJA.0000000000000450.
BACKGROUND
Postoperative cognitive dysfunction (POCD) may be related to the systemic inflammatory response and an increase in serum markers of brain injury such as S100B protein and neuron-specific enolase (NSE).
OBJECTIVE
The study aims to evaluate the association between POCD and serum levels of S100B and NSE after coronary artery bypass grafting surgery (CABG).
DESIGN
Prospective observational study.
SETTING
Single university teaching hospital.
PATIENTS
We investigated 88 patients undergoing CABG.
MAIN OUTCOMES MEASURES
Cognitive function was measured preoperatively, and at the 21st and 180th postoperative days (i.e. 6 months after surgery). S100B protein and NSE serum levels were evaluated preoperatively, after induction of anaesthesia, at the end of surgery and at 6 and 24 h after surgery.
RESULTS
The incidence of POCD was 26.1% at 21 days after surgery and 22.7% at 6 months after surgery. Increased serum levels of S100B protein and NSE were observed postoperatively and may indicate brain damage.
CONCLUSION
Although serum levels of S100B protein and NSE are both significantly increased postoperatively, our findings indicate that serum levels of S100B protein may be more accurate than NSE in the detection of POCD after CABG.
TRIAL REGISTRATION
NCT01550159.
背景
术后认知功能障碍（POCD）可能与全身炎症反应以及脑损伤血清标志物如S100B蛋白和神经元特异性烯醇化酶（NSE）升高有关。
目的
本研究旨在评估冠状动脉搭桥手术（CABG）后POCD与血清S100B和NSE水平之间的关联。
设计
前瞻性观察性研究。
地点
单一大学教学医院。
患者
我们调查了88例接受CABG的患者。
主要观察指标
术前、术后第21天和第180天（即术后6个月）测量认知功能。术前、麻醉诱导后、手术结束时以及术后6小时和24小时评估S100B蛋白和NSE血清水平。
结果
术后21天POCD发生率为26.1%，术后6个月为22.7%。术后观察到S100B蛋白和NSE血清水平升高，可能表明脑损伤。
结论
虽然术后S100B蛋白和NSE血清水平均显著升高，但我们的研究结果表明，在检测CABG术后POCD方面，S100B蛋白血清水平可能比NSE更准确。
试验注册
NCT01550159。
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