70、七氟烷对老年患血浆同型半胱氨酸的影响与术后认知功能相关性研究(高烨等).doc

七氟烷对老年患者血浆同型半胱氨酸的影响与术后认知功能相关性研究高烨，张邓新*，季永作者单位：苏州大学附属第四医院麻醉科，214062；* 通讯作者；基金项目：江苏省高校省级重点实验室课题（KJS09001）、无锡市医院管理中心医学科技发展基金项目（YGZ1008） I～Ⅱ级吸入高浓度七氟烷较吸入低浓度七氟烷更易引起术后认知功能障碍Hcy浓度与七氟烷的吸入浓度存在相关性 关键词：七氟烷，浓度，血清，同型半胱氨酸，老年，认知功能障碍 Abstract: Objective To investigate the influence of inhaling different consistency of sevoflurane on post-operative cognitive dysfunction in the elderly patients and to evaluate the correlation between serum of Hcy and POCD. Methods Sixty ASAI-Ⅱ patients undergoing lower gastrectomy were randomly assigned to two groups, group of inhaling low consistency of sevoflurane (group A, n=30) and group of inhaling high consistency of sevoflurane (group B, n=30). After the induction of anesthesia, 1.5% sevoflurane (group A) and 3.0% sevoflurane (group B) were given for anesthetic maintenance. The mimi-mental state examination (MMSE) was used to assess the cognitive function before and 6,24,72 h after the operation. The serum of Hcy before and 2 h in the operation and 24 h, 72 h after the operation were determined. Results MMSE scores before the operation were insignificant (P0.05). Compared with the preoperative values, MMSE scores were significantly reduced at 6 h in group A and group B (P0.05), and MMSE scores at 6 h in group B were lower than those in group A (P0.05). Compared with the preoperative values, the serum of Hcy at 2 h in the operation and 24 h, 72 h after the operation in group A were risen but insignificant (P0.05), the serum of Hcy at 2 h in the operation were significantly risen (P0.05), but the serum of Hcy at 24 h, 72 h after the operation in group B returned to baseline (P0.05). Conclusion Inhaling high consistency of sevoflurane was easier to result in POCD than inhaling low consistency of sevoflurane. Consistency of serum of Hcy has a certain correlation with the consistency of inhaling sevoflurane. Key words: sevoflurane, consistency, serum, Hcy, elderly, POCD 术后认知功能障碍 （postoperative cognitive dysfunction，POCD）是老年患者术后常见的神经系统并发症[1]