【摘要】 目的观察依达拉奉对老年患者围术期炎性反应及术后认知功能障碍(POCD)的影响。方法择期行髋关节置换术的老年患者48例,年龄65~79岁,ASAⅠ或Ⅱ级,简易精神状态检查量表(MMSE)评分>24分,随机分为依达拉奉组(E组)和对照组(C组)。E组全麻诱导后静注依达拉奉0.5mg/kg;C组静注等量生理盐水。分别于麻醉诱导后(T1)、手术开始1h(T2)、拔管后1h(T3)和术后24h(T4)抽取静脉血测定血浆TNF-α、IL-6、IL-10水平。术前1d及术后3、5、7d通过MMSE评分对认知功能进行评估,术后MMSE评分较术前减少≥2分则判定为POCD。结果与T1时比较,T2~T4时两组患者TNF-α、IL-6、T3、T4时两组IL-10水平明显升高(P<0.05)。与术前比较,术后3、5d两组患者MMSE评分明显降低(P<0.05)。与C组比较,T3、T4时E组患者TNF-α、IL-6水平明显降低(P<0.05),术后3、5dE组的MMSE评分明显增高(P<0.05)。E组术后发生POCD 3例,明显少于C组9例(P<0.05)。结论依达拉奉可抑制围术期炎性因子的水平,降低POCD的发生。更多还原

【Abstract】 Objective To investigate the effects of edaravone on perioperative inflammatory response and postoperative cognitive function in aged patients.Methods Forty-eight ASA ⅠorⅡelderly patients with MMSE score>24,aged 65-79 year sold,scheduled for elective hip surgeries were randomly divided into the edaravone group(group E)and the control group(group C).Group E patients received edaravone 0.5mg/kg and group C received the same volume of saline.The blood samples were reserved after anesthesia induction(T1),1hafter the beginning of operation(T2),1hafter extubation(T3)and 24 hafter operation(T4)for detecting the concentrations of TNF-α,IL-6and IL-10.Cognitive function was also evaluated at 3,5 and 7 d after operation using MMSE.Results Compared with the group C,the concentrations of TNF-αand IL-6 were significant decreased at T3 and T4and the MMSE scores were increased at 3dand 5dafter operation in group E(P<0.05).Conclusion Edaravone can reduce postoperative inflammatory response and the incidence of early period POCD.更多还原