摘要
目的探讨心脏体外循环术后患者血清tau蛋白、β-淀粉样蛋白(amyloidβ-protein, Aβ)含量与认知功能障碍(postoperative cognitive dysfunction, POCD)的相关性。方法筛选择期行心脏体外循环手术患者于术前1天、术后第7天全套量表法评估精神神经功能。分别于手术前5分钟、体外循环术后1、6、24小时以及术后第3天、第7天定时采取静脉血4 ml,酶联免疫吸附测定法检测血清Aβ1-40、Aβ1-42蛋白、tau蛋白水平。术后根据认知功能评估结果将所有患者分为POCD组以及非POCD组,应用统计学分析两组在每一种蛋白血清水平的差异,验证血清中三种蛋白对心脏低温体外循环术后认知功能障碍检测的准确性和可靠性。结果总计108例患者纳入统计,按量表评估结果,其中POCD 39例,非POCD 69例,POCD发生率为36.1%,围术期资料分析,年龄是POCD的危险因素(t=2.760,P=0.007 <0.05),与术前相比,术后患者POCD组血清tau蛋白、Aβ蛋白均有升高,但两组比较仅血清tau蛋白差异有统计学意义(P <0.05)。结论①年龄为术后认知功能障碍发生的重要高危因素;②心脏手术后POCD组患者血清tau蛋白明显高于非POCD组;③tau蛋白与术后认知功能障碍密切相关,其早期明显升高对于POCD的诊断有重要意义。
Objective To explore the correlation among the serum biomarkers including tau protein,beta amyloid protein and postoperative cognitive dysfunction associated cardiopulmonary bypass.Methods The cognitive dysfunction of all the patients undergoing cardiac valve surgery with cardiopulmonary bypass were accessed with authority scales at preoperative stage and 7 days after operation.All the blood samples from this patient were obtained at preoperative stage,1 hour after cardiopulmonary bypass(CPB),6 hour after CPB,1 day after operation,3 days after operation and 7 days after operation,and they were analyzed by ELISA with tau protein levels,serum amyloid beta protein.After the operation,patients were divided into 2 groups[(postoperative cognitive dysfunction,POCD)and non-POCD]according to the results of the scales,and then the serum biomarkers levels of the two groups were compared and the reliability and accuracy of the three markers associated with the postoperative cognitive dysfunction after CPB were accessed.Results The incidence of POCD is 36.1%(39 out of 108 patients).The data showed that age is one of the risk factors of POCD after CPB.All the three biomarkers rises after CPB.However,the tau protein at the 1-hour and 6-hour time point were both significantly elevated in the presence of POCD.Conclusions①Age is one of the risk factors of POCD.②Serum levels of tau protein were significantly higher in patients with POCD after cardiac surgery.③Tau protein is closely related to POCD,and it plays a significant role in the early diagnosis of POCD after CPB.
作者
陈远翔
龙剑
翁国星
张伟卫
赖力
王欢
Chen Yuan-xiang;Long Jian;Weng Guo-xing;Zhang Wei-wei;Lai Li;Wang Huan(Department of Cardio-Thoracic Surgery,Fujian Provincial Hospital,Fuzhou 350001;Key Laboratory of Cardiovascular,Fujian provincial hospital,Fuzhou 350001)
出处
《创伤与急诊电子杂志》
2018年第3期125-130,共6页
Journal of Trauma and Emergency(Electronic Version)
基金
福建省自然科学基金(2014J01292)
关键词
术后认知功能障碍
体外循环
TAU蛋白
Β-淀粉样蛋白
Postoperative cognitive dysfunction
Cardiopulmonary bypass
Serum tau protein
Serum amyloid beta protein
