青岛大学医学院学报2017，Vol.53Issue(5)：511-514,518,5.DOI:10.13361/j.qdyxy.201705003
右美托咪定对老年病人术后认知功能及外周血IGF-1和Aβ水平的影响
EFFECTS OF DEXMEDETOMIDINE ON POSTOPERATIVE COGNITIVE FUNCTION AND THE LEVELS OF IGF-1 AND Aβ IN PERIPHERAL BLOOD IN ELDERLY PATIENTS
摘要
Abstract
Objective To investigate the effects of dexmedetomidine on postoperative cognitive function and the levels of insulin-like growth factor-1 (IGF-1) and beta-amyloid protein (Aβ) in peripheral blood in elderly patients.Methods Sixty patients aged 65-80 years,ASA Ⅱ or Ⅲ,who underwent selective laparoscopic gastrectomy under general anesthesia,were randomly and equally divided into two groups:control group (group C) and dexmedetomidine group (group D).After induction of general anesthesia,group D received a dexmedetomidine loading dose of 1.0μg/kg iv over 15 min,followed by intravenous infusion at 0.5 μg/(kg · h) until 30 min before the end of the operation;group C was given the same volume of normal saline.Peripheral venous blood samples were taken before anesthesia induction (T0) and at 1,3,and 7 d after operation (T1,T2,and T3),the levels of serum IGF-1 and Aβ were determined by ELISA.Cognitive function was assessed using the Mini-Mental State Examination (MMSE) at 1 day before operation and 7 d and 1 month postoperatively.Results In both groups,serum Aβ was significantly higher at T1-T3 than at T0 (F=75.89,P＜0.05),and serum IGF-1 was significantly lower at T1-T3 than at T0 (F=26.60,P＜0.05).Compared with group C,group D had significantly reduced serum Aβ and significantly increased serum IGF-1 at T1-T3 (t =2.20-16.33,P＜0.05).The incidence of postoperative cognitive dysfunction (POCD) was 36.7％ in group C versus 10.0％ in group D at T3 (x2=4.57,P＜0.05).Both groups had a significantly lower MMSE score at T3 than at T0 (t=2.14,5.42;P＜0.05);group D had a significantly increased MMSE score compared with group C at T3 (t =7.02,P ＜ 0.05);MMSE score increased to the preoperative level at 1 month after operation in the two groups (P＞0.05).Conclusion Dexmedetomidine can effectively reduce the incidence of POCD in a few days after operation,possibly by regulating serum levels of IGF-1 and Aβ.关键词
右美托咪啶/认知障碍/胰岛素样生长因子Ⅰ/淀粉样β肽类Key words
dexmedetomidine/cognition disorders/insulin-like growth factor Ⅰ/amyloid beta-peptides分类
医药卫生引用本文复制引用
马玉峰,于京福,王彬,毕燕琳..右美托咪定对老年病人术后认知功能及外周血IGF-1和Aβ水平的影响[J].青岛大学医学院学报,2017,53(5):511-514,518,5.基金项目
青岛市市南区科技局立项课题(2014-14-032-YY) （2014-14-032-YY）
