【摘要】 目的 分析全身麻醉患者血清神经元特异性烯醇化酶(NSE)、神经生长因子(NGF)、微小核糖核酸-143-3p (miR-143-3p)、β-淀粉样蛋白水平变化与围术期神经认知障碍的相关性。方法 选取2023年1月至2025年1月新乡医学院第一附属医院收治的95例全身麻醉患者为研究对象，并依据简易精神状态检查量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分是否低于26分，分为小于26分的神经认知障碍组(n=20)与高于26分的神经认知正常组(n=75)。比较两组的一般临床资料，使用多因素Logistic回归分析影响患者发生围术期神经认知障碍的风险因素，Spearman相关性分析血清NSE、NGF、β-淀粉样蛋白、miR-143-3p水平与围术期发生神经认知障碍的相关性。结果 神经认知障碍组教育年限显著低于神经认知正常组，麻醉时间、糖尿病、手术时间、高血压、冠心病、术中低血压、术中出血量、高脂血症高于神经认知正常组，差异有统计学意义(P<0.05)。Spearman相关性分析结果显示NSE、β-淀粉样蛋白水平与围术期神经认知障碍呈正相关，NGF、miR-143-3p水平与围术期神经认知障碍呈负相关(P<0.05)。多因素Logistic回归分析结果显示，术中低血压、MMSE、miR-143-3p水平、MoCA评分、糖尿病、教育年限、麻醉时间、NSE、NGF、β-淀粉样蛋白、手术时间、高血压、术中出血量、冠心病、高脂血症均是影响围术期发生神经认知障碍的风险因素(P<0.05)。结论 全身麻醉患者血清NSE、β-淀粉样蛋白、NGF、miR-143-3p水平变化与围术期神经认知障碍之间关系密切，且NSE、β-淀粉样蛋白水平与围术期神经障碍认知呈正相关，NGF、miR-143-3p水平与围术期神经障碍认知呈负相关，是影响患者围术期发生神经认知障碍的风险因素。更多还原

【Abstract】 Objective To analyze the relationship between changes in serum neuron-specific enolase(NSE), nerve growth factor(NGF), micro ribonucleic acid-143-3p(miR-143-3p), β-amyloid levels and perioperative neurocognitive deficits in patients under general anesthesia. Methods A total of 95 patients under general anesthesia admitted to the First Affiliated Hospital of Xinxiang Medical University from January 2023 to January 2025 were selected as the research subjects. According to whether their Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA) scores were lower than 26 points, they were divided into the neurocognitive impairment group with scores less than 26 points(n=20) and the neurocognitive normal group with scores higher than 26 points(n=75). The general clinical data of the two groups were compared. Multivariate Logistic regression analysis was used to analyze the risk factors influencing the occurrence of perioperative neurocognitive impairment in patients. Spearman correlation analysis was used to analyze the correlations between the levels of serum NSE, NGF, β-amyloid protein, miR-143-3p and the occurrence of perioperative neurocognitive impairment. Results The years of education in the neurocognitive impairment group were significantly shorter than those in the neurocognitive normal group, while the anesthesia time, diabetes, operation time, hypertension, coronary heart disease, intraoperative hypotension, intraoperative blood loss, and hyperlipidemia were higher than those in the neurocognitive normal group, and the differences were significant(P<0.05). Spearman correlation analysis showed that the levels of NSE and β-amyloid protein were positively correlated with perioperative neurocognitive disorders, while the levels of NGF and miR-143-3p were negatively correlated with perioperative neurocognitive disorders(P<0.05). Multivariate Logistic regression analysis showed that intraoperative hypotension, MMSE, miR-143-3p level, MoCA score, diabetes, years of education, anesthesia time, NSE, NGF, β-amyloid protein, operation time, hypertension, intraoperative blood loss, coronary heart disease, and hyperlipidemia are all risk factors affecting the occurrence of neurocognitive impairment during the perioperative period(P<0.05). Conclusions There is a close relationship between changes in serum NSE, β-amyloid, NGF, miR-143-3p levels and perioperative neurocognitive impairment in general anesthesia patients, and NSE, β-amyloid levels are positively correlated with perioperative neurocognitive impairment, while NGF, miR-143-3p levels are negatively correlated with perioperative neurocognitive impairment, which are risk factors for the occurrence of neurocognitive deficits in the perioperative period.更多还原