【摘要】 目的 探讨脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)及S100B蛋白与老年髋关节手术患者术后谵妄的关系。方法 回顾性分析2014年3月至2015年3月于北京市平谷区医院因单侧髋关节骨折行髋关节手术的65岁以上患者共97例,根据是否出现术后谵妄分为谵妄组(20例)和非谵妄组(77例)。采集2组患者术前和术后24 h的血清标本,测定并比较2组BDNF、NSE和S100B蛋白浓度。分析血清BDNF、NSE和S100B蛋白浓度与术后谵妄的关系。结果 2组患者术后血清BDNF浓度均明显高于术前[非谵妄组:(2 031±660)ng/L比(1 393±622)ng/L,P<0.05;谵妄组:(2 146±462)ng/L比(1 709±674)ng/L,P<0.05];且谵妄组患者术前血清BDNF浓度明显高于非谵妄组(P<0.05)。2组患者血清NSE[术前:(12.1±2.3)μg/L比(12.5±2.7)μg/L;术后:(12.2±2.7)μg/L比(12.0±2.2)μg/L]、S100蛋白[术前:(1 235±286)ng/L比(1 241±257)ng/L;术后:(1 233±273)ng/L比(1 179±247)ng/L]浓度及术后血清BDNF浓度差异均无统计学意义(P>0.05)。二分类Logistic回归分析显示术前血清BDNF浓度升高与术后谵妄的发生有相关性(比值比:3.417,95%置信区间:1.130~10.333,P=0.030)。结论 老年髋关节手术患者术前BDNF升高与术后谵妄发生有关。更多还原

【Abstract】 Objective To investigate relation among brain-derived neurotrophic factor(BDNF),neuron specific enolase(NSE),SIOOB protein and postoperative delirium in elderly patients with hip joint operation.Methods Totally 97 patients over 65 years old had unilateral hip joint operation from March 2014 to March 2015 in Beijing Pinggu Hospital were retrospectively analyzed and divided into 2 groups according to the occurrence of postoperative delirium;delirium group(20 cases)and non-delirium group(77 cases).Serum levels of BDNF,NSE and SIOOB protein were measured before and 24 h after operation.Relation among serum BDNF,NSE,S100 B protein and postoperative delirium was analyzed.Results Postoperative serum levels of BDNF were significantly higher than those before operation in both groups[non-delirium group:(2 031 ±660) ng/L vs(1 393 ±622) ng/L,P<0.05;delirium group:(2 146 ±462) ng/L vs(1 709 ±674) ng/L,P < 0.05].The preoperative serum level of BDNF in delirium group was significantly higher than that in non-delirium group(P<0.05).Serum levels of NES[preoperative;(12.1 ± 2.3) μg/L vs(12.5 ± 2.7) μg/L;postoperative;(12.2 ± 2.7) μg/L vs(12.0±2.2)μg/L],S100 B protein[preoperative:(1 235 ± 286) ng/L vs(1 241 ±257) ng/L;postoperative;(1 233 ±273) ng/L vs(1 179 ±247) ng/L]and the postoperative serum level of BDNF had no significant differences between groups(P > 0.05).Binomial logistic regression analysis showed that elevated preoperative BDNF had correlation with postoperative delirium(Odds Ratio;3.417,95%Confidence Interval;1.130-10.333,P = 0.030).Conclusion Elevated preoperative BDNF is conelated with the occurance of postoperative delirium in elderly people with hip joint operation.更多还原