摘要
目的 探讨ABO血型因素对老年患者术后认知功能的影响.方法 选择胸科手术老年患者120例,年龄65～75岁,BMI 17～26 kg/m2,ASA分级Ⅰ或Ⅱ级.根据ABO血型分为4组（n=30）：A型血组（A组）、B型血组（B组）、O型血组（O组）和AB型血组（AB组）.采用全麻联合硬膜外麻醉,术后行自控硬膜外镇痛,维持VAS评分≤4分.于术前（T0）及术后6 h（T1）、24 h（T2）、72 h（T3）时进行简易智能量表评分（MMSE）,记录术后认知功能障碍（POCD）的发生情况.于上述各时点抽取中心静脉血样,采用ELISA法测定血清神经元特异性烯醇化酶（NSE）和S-100β蛋白的浓度.结果 与T0时比较,A组、B组、AB组T1-T3时、O组T1和T2时MMSE评分降低,血清NSE和S-100β蛋白浓度升高（P＜0.05）.与A组比较,B组、AB组、O组T1-T3时MMSE评分升高,血清NSE和S-100β蛋白浓度降低（P＜0.05）.与O组比较,B组和AB组T1-T3时MMSE评分降低,血清NSE和S-100β蛋白浓度升高（P＜0.05）.B组和AB组T1-T3时MMSE评分和血清NSE和S-100β蛋白浓度比较差异无统计意义（P＞0.05）.POCD发生率由高到底依次为A组＞AB组＞B组＞O组（P＜0.05或0.01）.结论 ABO血型因素可影响老年患者术后认知功能,A型血老年患者易发生POCD,O型血老年患者发生POCD的几率相对较低.
Objective To investigate the effects of ABO blood group factors on postoperative cognitive function in elderly patients.Methods One hundred twenty patients, aged 65-75 yr, with body mass index of 17-26 kg/m2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective thoracic surgery, were divided into 4 groups （n =30 each） according to the blood group： blood group A group （group A）, blood group B group （group B）, blood group O group （group O） and blood group AB group （group AB）.Combined general-epidural anesthesia was used during surgery, patient-controlled epidural analgesia was performed after surgery, and visual analogue scale score was maintained ≤4.Before surgery （T0）, and at 6, 24 and 72 h after surgery （T1-3）, Mini-Mental State Examination （MMSE） was used to assess the cognitive function, and the occurrence of postoperative cognitive dysfunction （POCD） was recorded.Blood samples were drawn from the central vein at T0-3 for determination of neuron-specific enolase （NSE） and S-100β protein concentrations in serum.Results Compared with the values at T0, MMSE scores were significantly decreased, and serum NSE and S-100β concentrations were increased at T1-3 in A, B and AB groups, and at T1 and T2 in group O （P〈0.05）.Compared with group A, MMSE scores were significantly increased, and serum NSE and S-100β concentrations were decreased at T1-3 in B, AB and O groups （P〈0.05）.Compared with group O, MMSE scores were significantly decreased, and serum NSE and S-100β concentrations were increased at T1.3 in B and AB groups （P〈0.05）.There was no significant difference in MMSE scores and serum NSE and S-100β concentrations at T1-3 between group B and group AB （P〉0.05）.The incidence of POCD from the high to the low was group A, group AB, group B, and group O in turn （P〈0.05 or 0.01）.Conclusion ABO blood group factors affect postoperative cognitive function in elderly patients, elderly patients of blood group
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2015年第11期1331-1334,共4页
Chinese Journal of Anesthesiology
关键词
ABO血型系统
老年人
手术后并发症
认知障碍
ABO blood-group system
Aged
Postoperative complications
Cognition disorders
