α抗糜蛋白酶的表达与术后认知功能障碍的相关性研究.DOC

基金项目：浦东新区卫生局卫生科技项目基金（PW2011A-9）；浦东新区卫生系统优秀青年医学人才培养计划（PWRq-2012-16） 作者单位： 200135，上海市浦东新区公利医院疼痛科（施丽燕 徐静 万燕杰） 通信作者： HYPERLINK mailto:徐静，电子邮箱为djxx01@ 徐静，电子邮箱为djxx02@163.com 外周血α1-抗糜蛋白酶的表达与术后认知功能障碍发生的临床研究 施丽燕 徐静 万燕杰 【摘要】目的 研究术后认知功能障碍（POCD）与外周血α1–抗糜蛋白酶（α1-antichymotrypsin，ACT）的关系。方法 选择全身麻醉下行普外科手术患者60例，在术前1 d和术后7d采用成套神经心理测验（Battery of Cognitive Assessment Instruments，BCAI）评价患者认知功能。在术前1 d、术毕和术后7d分别采血，检测α1–抗糜蛋白酶。结果 在60例患者中，术后7天发生POCD有18例，POCD的发生率为30%。ACT表达在术前POCD组与非POCD组比较无差异。ACT的表达在POCD组术毕、术后7天分别比非POCD组表达升高(P0.05)。ACT的表达在POCD组、非POCD组术毕、术后7天分别比术前表达升高(P0.05)。结论 POCD的发生与血浆中ACT的表达增高有关。 【关键字】术后认知功能障碍；β-淀粉样蛋白；α1–抗糜蛋白酶 Relationship between postoperative cognitive dysfunction and the expression of α1-antichymotrypsin in plasma *SHI Liyan, WAN Yanjie. *Department of Pain clinic, GongLi Hospital,Pudong, Shanghai 200135,China Corresponding author: WAN Yanjie, E-mail:yanjie.wan@ 【Abstract】Objective　To investigate the relationship between the expression of α1-antichymotrypsin in plasma and postoperative cognitive dysfunction（POCD）. Methods　The cognitive function of 60 patients undergoing operation under general anesthesia was evaluated by a battery of cognitive assessment instruments（BCAI）1 d preoperatively and 7 d postoperatively. The levels of α1-antichymotrypsin were detected at the time set in advance. Results　 18 cases of patients were judged cognitive dysfunction and the remaining non-cognitive dysfunction. Compared with non-cognitive dysfunction group, levels of α1-antichymotrypsin postoperation immediately and 7-day postoperation were significantly higher in POCD group ( P0.05) .The expressions of α1-antichymotrypsin preoperation in POCD group and in non-cognitive dysfunction group were not significant ( P0.05). Levels of α1-antichymotrypsin postoperation immediately and 7-day postoperation were significantly higher than preoperation separately in both POCD group( P0.05) and non-cognitive dysfunction group( P0.05). Conclusion POCD is associated with high expression