【摘要】 目的 分析血清微小RNA-29c(miR-29c)对乳腺癌患者全麻术后认知障碍(PCOD)的预测价值。方法 回顾性分析110例乳腺癌患者的临床资料，患者均在全身麻醉下行乳腺癌根治术，统计入组患者PCOD发生率，将其分别列为PCOD组(20例)、非PCOD组(90例),分析乳腺癌全身麻醉PCOD的危险因素，血清miR-29c对PCOD的预测价值。结果 PCOD组的年龄、合并高血压占比、合并脑血管病占比、合并睡眠障碍占比、静吸复合麻醉占比、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、神经元特异性烯醇化酶(NSE)、中枢神经特异蛋白(S100β)水平均高于非PCOD组，miR-29c、简易精神状态量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分低于非PCOD组(t/χ~2=2.320,4.488,11.062,16.296,10.027,2.385,2.956,2.299,2.338,2.625,2.877,2.174;P<0.05)。合并睡眠障碍、麻醉方式、TNF-α、IL-1β、NSE、S100β、MMSE、MoCA、miR-29c为乳腺癌全麻术后继发PCOD的危险因素。miR-29c、MMSE、MoCA联合检测预测乳腺癌全麻术后继发PCOD的灵敏度、特异度均高于miR-29c、MMSE、MoCA单独检测。结论 miR-29c低表达为乳腺癌患者全麻术后继发PCOD的危险因素之一，联合检测miR-29c、MMSE及MoCA能早期预测PCOD发生风险。更多还原

【Abstract】 Objective To analyze the predictive value of serum miR-29c on PCOD after general anesthesia for breast cancer.Methods Retrospectively analyzed the case data of 110 breast cancer patients.All patients received radical surgery for breast cancer under general anesthesia.Count the incidence of PCOD of the patients in the group, and classify them into PCOD group(20 cases)and non PCOD group(90 cases),analyze the risk factors of PCOD under general anesthesia for breast cancer, and the predictive value of serum miR-29c for PCOD.Results Aage, proportion of hypertension, proportion of cerebrovascular disease, proportion of sleep disorders, proportion of combined anesthesia, TNF-α,IL-1β,NSE,and S100β in the PCOD group were all higher than those in the non PCOD group, miR-29c、 The scores of MMSE and MoCA were lower in the non PCOD group(t/χ~2=2.320,4.488,11.062,16.296,10.027,2.385,2.956,2.299,2.338,2.625,2.877,2.174;P<0.05).The risk factors of secondary PCOD after general anesthesia for breast cancer were sleep disorder, anesthesia mode, TNF-α,IL-1β,NSE,S100β,MMSE,MoCA and miR-29c.The sensitivity and specificity of miR-29c, MMSE and MoCA combined detection in predicting PCOD after general anesthesia for breast cancer were higher than those of miR-29c, MMSE and MoCA alone.Conclusion The low expression of miR-29c is one of the risk factors of secondary PCOD in breast cancer patients after general anesthesia.The combined detection of miR-29c, MMSE and MoCA can achieve early prediction of the risk of PCOD.更多还原