Qin Yang, Ni Jinping, Kang Li, Zhong Zhidong, Wang Liren, Yin Shuzhou
Department of Anesthesiology, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, Suzhou, 215028, China.
J Coll Physicians Surg Pak. 2019 Jan;29(1):12-15. doi: 10.29271/jcpsp.2019.01.12.
To investigate the effects of sustained inhalation of sevoflurane on cognitive function and the expression of oxidative stress response proteins such as NADPH oxidase subunits NOX2 and NOX4 in elderly patients undergoing radical surgery for lung cancer.
An experimental study.
Department of Anesthesiology, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, China, from February 2016 to October 2017.
Elderly patients who underwent radical surgery for lung cancer were divided into the sevoflurane group and the propofol group, with 52 cases in each group. Sustained inhalation of sevoflurane and propofol was administered to maintain anesthesia in the respective groups. Cognitive function and lung function parameters were compared between the two groups. Serum S100 β levels and expression of NOX2 and NOX4 proteins in peripheral blood mononuclear cells of the two groups were determined.
At 24 hours after surgery, the lung function indices of the sevoflurane group such as FEV1, FVC and VC were higher than those of the propofol group (p<0.001, p=0.008 and p=0.002, respectively). At the end of the surgery and at 24 hours after surgery, the MMSE scores of the sevoflurane group were higher than the propofol group (all p<0.001). S100 levels were lower than the propofol group (p=0.003 and p<0.001, respectively). Levels of NADPH oxidase subunits NOX2 and NOX4 proteins in peripheral blood mononuclear cells of the sevoflurane group were lower than the propofol group (p=0.033, p<0.001, p<0.001and p<0.001, respectively).
Compared with intravenous anesthesia with propofol, general anesthesia with sevoflurane inhalation has little effect on the short-term cognitive function in elderly patients undergoing radical surgery for lung cancer, and can effectively improve lung function. The mechanism may be related to the reduction of the expression of NOX2 and NOX4 proteins.
探讨老年肺癌根治术患者持续吸入七氟醚对认知功能及烟酰胺腺嘌呤二核苷酸磷酸（NADPH）氧化酶亚基NOX2和NOX4等氧化应激反应蛋白表达的影响。
实验研究。
2016年2月至2017年10月，中国上海交通大学医学院附属苏州九龙医院麻醉科。
将老年肺癌根治术患者分为七氟醚组和丙泊酚组，每组52例。分别持续吸入七氟醚和丙泊酚维持麻醉。比较两组患者的认知功能和肺功能参数。测定两组患者血清S100β水平及外周血单个核细胞中NOX2和NOX4蛋白的表达。
术后24小时，七氟醚组的第一秒用力呼气容积（FEV1）、用力肺活量（FVC）和肺活量（VC）等肺功能指标高于丙泊酚组（分别为p<0.001、p=0.008和p=0.002）。手术结束时及术后24小时，七氟醚组的简易精神状态检查表（MMSE）评分高于丙泊酚组（均为p<0.001）。S100β水平低于丙泊酚组（分别为p=0.003和p<0.001）。七氟醚组外周血单个核细胞中NADPH氧化酶亚基NOX2和NOX4蛋白水平低于丙泊酚组（分别为p=0.033、p<0.001、p<0.001和p<0.001）。
与丙泊酚静脉麻醉相比，七氟醚吸入全麻对老年肺癌根治术患者短期认知功能影响较小，并能有效改善肺功能。其机制可能与NOX2和NOX4蛋白表达降低有关。
