中国体外循环杂志2023，Vol.21Issue(6)：336-341,6.DOI:10.13498/j.cnki.chin.j.ecc.2023.06.05
还原型谷胱甘肽对全麻心脏术后患者脑损伤标志物和认知功能的影响
The effect of reduced-glutathione on brain injury markers and cognitive func-tion in patients after general anesthesia cardiac surgery
摘要
Abstract
Objective To explore the protective effect of reduced-glutathione(GSH)on brain injury in patients undergo-ing cardiac surgery with cardiopulmonary bypass(CPB)by general anesthesia.Methods 140 patients who underwent elective heart valve surgery with CPB in our hospital from January 2020 to December 2022 were randomly divided into an observation group and a control group,with 70 cases in each group.All patients were treated with the same anesthesia regimen.After success-ful anesthesia induction,the observation group was injected with GSH via the internal jugular vein,while the control group was injected with an equal amount of physiological saline.The incidence of postoperative cognitive impairment and the Mini Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)score before,3 days after,and 1 week after surgery were compared.The brain injury markers and inflammatory factors at immediately after anesthesia induction(T0),30 minutes af-ter CPB initiation(T1),end of surgery(T2),6 hours after surgery(T3),24 hours after surgery(T4),and 72 hours after surgery(T5)were also compared.Results The incidence of postoperative cognitive impairment in the observation group was 7.14％,sig-nificantly lower than 22.86％in the control group(P<0.05).There was no statistically significant difference in various indicators between the two groups before surgery(P>0.05);The MMSE score and MoCA score in the observation group were significantly higher than those in the control group 3 days after surgery(P<0.05).Both groups'serum neuron specific enolase(NSE),S100 β protein and tumor necrosis factor-α(tumor necrosis factor-α,TNF-α),interleukin-6(IL-6)were continuesly increased at T1,T2,and T3,decreased at T4,and generally returned to T0 levels at T5;Serum NSE,S100 and TNF-α,IL-6 in the observation group at T1,T2,T3,and T4 time points were significantly lower than those in the control group(P<0.05),and the differences were statistically significant(P<0.05)after comparing the interaction effects between groups at different time points.There was no statistically significant difference in perioperative BIS,MAP,HR,anesthetic dosage,automatic rebound rate,and incidence of heart rate arrhythmia between the two groups(P>0.05).Conclusions GSH can significantly reduce the incidence of postopera-tive cognitive impairment,alleviate neurological damage,and alleviate inflammatory response in patients undergoing cardiac sur-gery with CPB.关键词
还原型谷胱甘肽/心肺转流/心脏瓣膜手术/认知功能障碍/神经损伤标志物/脑保护Key words
Reduced-glutathione/Cardiopulmonary bypass/Heart valve surgery/Cognitive dysfunction/Nerve injury markers/Cerebral protection引用本文复制引用
闫立会,刘志飞,闫建敏,苗振华..还原型谷胱甘肽对全麻心脏术后患者脑损伤标志物和认知功能的影响[J].中国体外循环杂志,2023,21(6):336-341,6.基金项目
邢台市重点研发计划项目(2022ZC193) （2022ZC193）
