乌司他丁对老年眼眶肿瘤患者术后认知功能障碍的影响.docVIP

乌司他丁对老年眼眶肿瘤患者术后认知功能障碍的影响 徐丽丽 严敏 沈建军 【摘要】 目的 本研究旨在探讨乌司他丁对老年眼眶肿瘤患者术后认知功能障及Tau蛋白及β-淀粉样蛋白（Aβ）水平的影响 方法 择期行眼眶肿瘤摘除术的老年患者80例，年龄≥65岁， ASA I或Ⅱ级，随机分为两组：乌司他丁组(U组)和对照组(C组)，每组40例。乌司他丁组在手术切皮前(10000U／kg)、术后第l、2、3天5000U／kg缓慢静脉注射乌司他丁；对照组给予等量生理盐水。术前1d和术后3d用简易智能状态检查法(MMSE)进行认知功能测试，以术后 MMSE评分下降大于或等于术前1个标准差评定为术后认知障碍，于术前(T0)、术毕(T1)、术后3 h(T2)、1d (T3)、3d(T4)测定血清Tau蛋白及Aβ蛋白含量。结果 术前与术后3d MMSE评分差值 U组低于C组。C组l0例发生认知障碍(2 5％)，U组l例发生( 2．5％Tau蛋白及Aβ蛋白浓度高于T0，U组 T1～3血清Tau蛋白及Aβ蛋白浓度升高幅度低于C组(P0.05)。结论 乌司他丁能降低老年眼眶肿瘤患者Tau蛋白及Aβ蛋白水平，这说明它在一定程度上减轻和预防术后认知障碍的发生，具有脑保护作用。 【关键词】乌司他丁；眼眶肿瘤; 认知功能 Effect of ulinastatin on post-operative cognition disorders in elderly patients undergoing orbital tumors surgery XU Lili, YA Min, SHEN Jianjun. The Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou 310012, China 【Abstract】 Objective To detect the effect of ulinastatin on post-operative cognition disorders and tau and Aβ protein level in elderly patients undergoing orbital tumors surgery. Methods Eighty ASAI-II patients, aged≥65 years, scheduled for orbital tumors surgery were randomly divided into 2 groups (n = 40 each): ulinastatin group and control group. After inducing anesthesia, ulinastatin group received intravenously 10,000 units/kg of ulinastatin before surgical incision, 5,000 units/kg after operation 1, 2, 3d respectively. Control group received the same volume of normal saline. Mini-Mental State Examination (MMSE) was performed one day before surgery and on the 3th post-operative day and POCD was defined as 1SD decline from baseline on neurocognitive assessment. Blood samples were obtained before inducing anesthesia, at the end of surgery, 3h, 1d and 3d after surgery for determination of serum tau and Aβ protein concentration. Results: In the control group, MMSE scores decreased on the 3th post-operative day as compared with before inducing anesthesia (p0.05). However, the ulinastatin group had higher MMSE scores on the 3th post-operative day than those in the control group (p0.05