Kumpaitiene Birute, Svagzdiene Milda, Drigotiene Ingrida, Sirvinskas Edmundas, Sepetiene Ramune, Zakelis Rolandas, Benetis Rimantas
1 Lithuanian University of Health Sciences, Kaunas, Lithuania.
2 Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
J Int Med Res. 2018 Sep;46(9):3621-3629. doi: 10.1177/0300060518776545. Epub 2018 Jun 13.
Objective This study was performed to investigate the correlation among decreased regional cerebral oxygen saturation (rSO), blood levels of brain injury biomarkers, and postoperative cognitive disorder (POCD) after cardiac surgery with cardiopulmonary bypass (CPB). Methods This prospective observational study included 59 patients undergoing coronary artery bypass graft surgery with CPB. All patients underwent neuropsychological tests (Mini Mental State Evaluation, Rey Auditory Verbal Learning Test, digit span test, digit symbol substitution test, and Schulte table) the day before and 10 days after the surgery. The blood levels of two brain injury biomarkers, neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP), were measured before and 1 day after the surgery. Results The rSO decreased during surgery in 21 (35%) patients. POCD was detected in 22 (37%) patients. After the surgery, no significant changes in the GFAP blood level occurred in any patients. No significant correlations were found among the decreased rSO, increased NSE blood level, and rate of POCD. Conclusion These results suggest that a decrease in rSO during cardiac surgery is not necessarily related to the development of POCD or an increased blood level of the brain injury biomarker NSE.
目的 本研究旨在探讨体外循环（CPB）心脏手术后局部脑氧饱和度（rSO）降低、脑损伤生物标志物血水平与术后认知障碍（POCD）之间的相关性。方法 这项前瞻性观察性研究纳入了59例行CPB冠状动脉搭桥手术的患者。所有患者在手术前一天和手术后10天均接受神经心理学测试（简易精神状态检查表、雷氏听觉词语学习测验、数字广度测验、数字符号替换测验和舒尔特方格）。在手术前和手术后1天测量两种脑损伤生物标志物神经元特异性烯醇化酶（NSE）和胶质纤维酸性蛋白（GFAP）的血水平。结果 21例（35%）患者在手术期间rSO降低。22例（37%）患者检测出POCD。手术后，所有患者的GFAP血水平均无显著变化。rSO降低、NSE血水平升高与POCD发生率之间未发现显著相关性。结论 这些结果表明，心脏手术期间rSO降低不一定与POCD的发生或脑损伤生物标志物NSE血水平升高有关。
