Yu Peng, Wang Hua, Mu Lei, Ding Xuemei, Ding Wei
Department of Anesthesiology, Traditional Chinese Medical Hospital of Rizhao, Rizhao, Shandong 276800, P.R. China.
Department of Otolaryngology, People's Hospital of Rizhao, Rizhao, Shandong 276800, P.R. China.
Exp Ther Med. 2016 Dec;12(6):3561-3566. doi: 10.3892/etm.2016.3814. Epub 2016 Oct 18.
The aim of the present study was to investigate the influence of general anesthesia on serum β-amyloid protein (Aβ) and regional cerebral oxygen saturation (rSO) of elderly patients after subtotal gastrectomy. From June, 2014 to December, 2015, among 168 patients undergoing subtotal gastrectomy, the Mini-Mental State Examination and Montreal Cognitive Assessment was administered the day prior to surgery and the second and ninth days after the operation. In addition, we administered the tests to 168 healthy adult volunteers (healthy controls) who were treated in our hospital medical center in the same period. Near-infrared spectroscopy technology was used for continuous monitoring of the intraoperative rSO, and the mean of intraoperative rSO was then calculated. Of the 168 patients, 28 developed postoperative cognitive dysfunction (POCD) and the remaining 140 patients were normal (control). The ELISA method was used to test the expression levels of serum Aβ in the three groups and statistical analyses were conducted. Serum Aβ level in the POCD group was significantly higher than that in the control and healthy control groups, and the difference was statistically significant (P<0.05). The rSO level in the patients with POCD was significantly lower than the control group (P<0.05). The correlation analysis with Aβ as an independent variable and other factors as dependent variables revealed that the serum Aβ level negatively correlated with rSO (r=-1.6749, P<0.05). The combined Aβ and rSO may be useful for the diagnosis and prevention of POCD after subtotal gastrectomy under general anesthesia.
本研究旨在探讨全身麻醉对老年患者胃大部切除术后血清β-淀粉样蛋白（Aβ）及局部脑氧饱和度（rSO）的影响。2014年6月至2015年12月，在168例行胃大部切除术的患者中，于手术前1天、术后第2天和第9天进行简易精神状态检查表和蒙特利尔认知评估。此外，我们对同期在我院医疗中心接受治疗的168名健康成年志愿者（健康对照组）进行了测试。采用近红外光谱技术持续监测术中rSO，并计算术中rSO的平均值。168例患者中，28例发生术后认知功能障碍（POCD），其余140例患者正常（对照组）。采用ELISA法检测三组血清Aβ表达水平并进行统计学分析。POCD组血清Aβ水平显著高于对照组和健康对照组，差异有统计学意义（P<0.05）。POCD患者的rSO水平显著低于对照组（P<0.05）。以Aβ为自变量、其他因素为因变量的相关性分析显示，血清Aβ水平与rSO呈负相关（r=-1.6749，P<0.05）。联合检测Aβ和rSO可能有助于全身麻醉下胃大部切除术后POCD的诊断和预防。
