[1]叶 姣.丙泊酚与七氟醚剂量配伍对合并轻度认知功能障碍的老年股骨颈骨折〖JZ〗患者围术期氧化应激反应及术后认知功能的影响*[J].陕西医学杂志,2019,(10):1298-1301.
　YE Jiao..Effects of propofol and sevoflurane on perioperative oxidative stress and postoperative cognitive〖JZ〗 function in elderly patients with femoral neck fracture complicated with mild cognitive impairment[J].,2019,(10):1298-1301.
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丙泊酚与七氟醚剂量配伍对合并轻度认知功能障碍的老年股骨颈骨折〖JZ〗患者围术期氧化应激反应及术后认知功能的影响*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年10期
页码:
1298-1301
栏目:
临床研究
出版日期:
2019-10-05

文章信息/Info

Title:
Effects of propofol and sevoflurane on perioperative oxidative stress and postoperative cognitive〖JZ〗 function in elderly patients with femoral neck fracture complicated with mild cognitive impairment
文章编号:
DOI:10.3969/j.issn.10007377.2019.10.014
作者:
叶 姣
陕西省商洛市中心医院麻醉科（商洛 726000）
Author(s):
YE Jiao.
Department of Anesthesiology,Shangluo Central Hospital in Shaanxi Province（Shangluo 726000）
关键词:
股骨颈骨折; 认知功能; 丙泊酚; 七氟醚; 剂量; 氧化应激
Keywords:
Key words 〖WT5BZ〗〖HT5”SS〗Femoral neck fracture; Cognitive function; Propofol; Sevoflurane; Dose; Oxidative stress
分类号:
R683
文献标志码:
A
摘要:
摘 要 目的：探讨丙泊酚与七氟醚剂量配伍对合并轻度认知功能障碍（MCI）的老年股骨颈骨折患者围术期氧化应激反应及术后认知功能的影响。方法：采用随机数字表法对62例合并MCI的老年股骨颈骨折患者进行分组。研究1组采用丙泊酚血浆靶浓度1.2 μg/ml和七氟醚吸入浓度为0.7%～1.2%的配比进行麻醉维持；研究2组则选择丙泊酚血浆靶浓度0.6 μg/ml和七氟醚吸入浓度为1.2%1.7%的配比进行麻醉维持。对比两组术前、术毕和术后6 h时血清氧化应激反应水平；对比两组术前和术后血清神经生长因子（NGF）、神经元特异性烯醇化酶（NSE）、血浆载脂蛋白J（ApoJ）水平和MoCA和MMSE评分变化。结果：术毕和术后6 h时，研究1组超氧化物歧化酶（SOD）和丙二醛（MDA）均明显低于研究2组，总抗氧化能力（TAOC）明显高于研究2组（P＜0.05）。术后1 d、3 d、7 d时，研究1组血清NGF和MoCA、MMSE评分均明显高于研究2组，NSE和ApoJ水平明显低于研究2组（P＜0.05）；且研究1组术后7 d时血清NGF、NSE、ApoJ和MoCA和MMSE评分均已恢复至术前水平（P＞0.05）。结论：丙泊酚血浆靶浓度1.2 μg/ml和七氟醚吸入浓度0.7%～1.2%进行麻醉维持不会加重MCI老年患者POCD病情，可作为合并MCI的老年股骨颈骨折术中麻醉维持的最佳配伍剂量。
Abstract:
Abstract 〖WT5BZ〗〖HT5”SS〗Objective:To investigate the effects of propofol and sevoflurane on perioperative oxidative stress and postoperative cognitive function in elderly patients with femoral neck fracture complicated with mild cognitive impairment (MCI).Methods:Sixtytwo patients with aged femoral neck fractures with MCI were randomized byrandom number table.Study group 1 was used propofol plasma target concentration of 1.2 μg/ml and sevoflurane inhalation concentration of 0.7% to 1.2% for maintenance of anesthesia.The study group 2 was used propofol plasma target concentration of 0.6 μg/ml and sevoflurane inhalation concentration of 1.2% to 1.7% for maintenance of anesthesia.The levels of serum oxidative stress in preoperative,postoperative and 6h postoperative was compared between two goups.Serum nerve growth factor (NGF),neuronspecific enolase (NSE),plasma apolipoprotein J (ApoJ) levels,and MoCA and MMSE scores were compared between two groups in preoperative and postoperative groups.Results:At the end of surgery and 6h after surgery,the superoxide dismutase (SOD) and malondialdehyde (MDA) in study group 1 were significantly lower than those in study group 2,and the total antioxidant capacity (TAOC) was significantly higher than that in study group 2 (P＜0.05).At 1d,3d and 7d after surgery,the serum NGF,MoCA and MMSE scores of the study group 1 were significantly higher than those of study group 2,and the levels of NSE and ApoJ were significantly lower than those of study group 2 (P＜0.05).The serum NGF,NSE,ApoJ,MoCA and MMSE scores of the study group 1 were restored to the preoperative level (P＞0.05).Conclusion:Propofol plasma target concentration 1.2μg/ml and sevoflurane inhalation concentration 0.7%1.2% for anesthesia maintenance will not aggravate POCD in elderly patients with MCI,and can be used as the best compatibility for anesthesia maintenance in elderly patients with MCI complicated with femoral neck fracture.

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备注/Memo

备注/Memo:
*陕西省自然科学基金资助项目(2014JM28199)
更新日期/Last Update: 2019-10-23