摘要
目的探讨右美托咪定对脑梗死(CI)患者髋关节置换术后认知功能及JAK2/STAT3信号通路的影响。方法选取2020年10月至2022年10月商丘市第一人民医院和郑州大学第一附属医院收治的CI致股骨颈骨折患者102例为研究对象,根据随机数表法分为研究组和对照组,各51例。研究组采用右美托咪定辅助麻醉,对照组采用常规麻醉。比较两组围手术指标、镇痛效果、认知功能、JAK2/STAT3信号通路蛋白水平及血清高迁移率族蛋白Bl(HMGBl)、基质金属蛋白酶-9(MMP-9)水平。结果两组手术时间、麻醉时间、麻醉苏醒时间、手术出血量、手术输液量比较差异无统计学意义(P>0.05);术后2 h、6 h研究组Ramsay评分高于对对照组,McGill评分低于对照组(P<0.05);术后1 d、3 d研究组蒙特利尔认知评估量表(MoCA)、神经行为认知状况测试量表(NCSE)、美国国立卫生研究组脑卒中量表(NIHSS)评分均高于对照组(P<0.05);术后1 d、3 d研究组JAK2、STAT3水平低于对照组(P<0.05);Spearman分析显示,MoCA、NCSE、NIHSS评分与JAK2水平均呈负相关(r=-0.516、-0.622、-0.539,P<0.001),与STAT3水平呈负相关(r=-0.420、-0.537、-0.453,P<0.001);术后1 d、3 d研究组HMGB1、MMP-9水平低于对照组(P<0.05);研究组不良反应发生率低于对照组的(P<0.05);与对照组相比,CI组小鼠脑组织p-JAK2、p-STAT3蛋白表达量显著上调,与CI组相比,低剂量组与高剂量组小鼠脑组织p-JAK2、p-STAT3蛋白表达量显著下调,其中高剂量组下调较低剂量组明显。结论右美托咪定应用于CI患者髋关节置换术患者可以提高镇痛效果,并通过抑制JAK2/STAT3信号通路,改善患者术后认识功能。
Objective To investigate the effects of dexmedetomidine on cognitive function and JAK2/STAT3 signaling pathway in patients with cerebral infarction(CI)after hip replacement.Methods A total of 102 patients with femoral fracture caused by CI admitted to the Shangqiu First People’s Hospital and the First Affiliated Hospital of Zhengzhou University from October 2020 to October 2022 were selected as the study objects,and were divided into study group and control group according to random number table method,with 51 cases in each group.The study group was given dexmedetomidine as adjuvant anesthesia and the control group was given The analgesic effects of surgical markers,cognitive function,JAK2/STAT3 pathway protein levels and serum high mobility group protein BL(HMGBL),matrix metalloproteinase-9(MMP-9),B lymphoma gene-2 protein(Bcl-2)/B lymphoma gene-2 associated X protein(Bax)levels were compared between the two groups.Results There were no significant differences in operation time,anesthesia time,anesthesia recovery time,surgical blood loss and surgical infusion volume between the two groups(P>0.05).The Ramsay score of the study group was higher than that of the control group at 2 h and 6 h after operation,and the McGill score was lower than that of the control group(P<0.05).The scores of Montreal Cognitive Assessment Scale(MoCA),Neurobehavioral Cognitive Status Test(NCSE)and National Health Research Group Stroke Scale(NIHSS)in the study group were higher than those in the control group on the 1 d and 3 d after operation(P<0.05).The levels of JAK2 and STAT3 in the study group were lower than those in the control group 1 d and 3 d after operation(P<0.05).Spearman analysis showed that MoCA,NCSE and NIHSS scores were negatively correlated with JAK2 levels(r=-0.516,-0.622,-0.539,P<0.001),and with STAT3 levels(r=-0.420,-0.537,-0.453,P<0.001).The levels of HMGB1 and MMP-9 in the study group were lower than those in the control group(P<0.05).The incidence of adverse reactions in study group was lower than that in contro
作者
朱永霞
孔莉
胡志超
朱照伟
Zhu Yongxia;Kong Li;Hu Zhichao;Zhu Zhaowei(Department of Anesthesiology,Shangqiu First People’s Hospital,Shangqiu 476100,China;Department of Urology,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华生物医学工程杂志》
CAS
2024年第2期103-110,共8页
Chinese Journal of Biomedical Engineering
基金
国家自然科学基金(81702503)
