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| 老年肺叶切除术患者围术期血清基质金属蛋白酶-9及脂联素浓度与术后谵妄的关系 |
| Relationship between the concentrations of matrix metalloproteinase-9 and adiponectin and postoperative delirium in perioperative serums of elderly patients undergoing lobectomy |
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| DOI：10.12089/jca.2019.02.012 |
| 中文关键词: 基质金属蛋白酶-9 脂联素 老年 肺叶切除术 术后谵妄 |
| 英文关键词: Metalloproteinase-9 Adiponectin Elderly Lobectomy Postoperative delirium |
| 基金项目:广东省东莞市社会科技发展重点项目（2017507150715001459）;广东省医学科研基金项目(C2018055) |
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| 中文摘要: |
目的 评价老年肺叶切除术患者围术期血清基质金属蛋白酶-9(matrix metalloprote- inase-9，MMP-9)及脂联素（adiponectin,ADP）浓度与术后谵妄(postoperative delirium, POD)的相关性。
方法 选择择期全麻下行肺叶切除术老年患者73例，男38例，女35例，年龄65~80岁，BMI<24 kg/m2，ASA Ⅰ或Ⅱ级，术后24、48和72 h采用中文版意识模糊评估量表评估认知功能,根据患者是否发生POD将患者分为两组：POD组和非POD组。于麻醉诱导前5 min（T0）、气管拔管即刻（T1）、术后24 h（T2）、术后48 h（T3）和术后72 h（T4）采集静脉血样，测定血清MMP-9及ADP浓度。
结果 13例患者发生POD，发生率为17.8%。与T0时比较，T1—T4时POD组血清MMP-9浓度明显升高, 血清ADP浓度明显降低（P<0.05）;T1时非POD组MMP-9浓度明显升高, 血清ADP浓度明显降低（P<0.05）。T1—T4时POD组血清MMP-9浓度明显高于,ADP浓度明显低于非POD组（P<0.05）。
结论 围术期血清MMP-9浓度升高与ADP浓度下降可能参与老年肺叶切除术患者POD发生的病理生理过程。 |
| 英文摘要: |
Ojective To evaluate the correlation between the concentrations of matrix metalloproteinase-9 (MMP-9) and adiponectin (ADP) and postoperative delirium (POD) in perioperative serum of elderly patients undergoing lobectomy.
Methods Seventy-three elderly patients undergoing lobectomy under general anesthesia, 38 males and 35 females, aged 65 - 80 years, BMI < 24 kg/m2, falling into ASA physical status Ⅰ or Ⅱ, were selected in some suitable period. All patients were divided into POD group and non-POD group according to the Chinese Version of Consciousness Assessment Scale at 24 hours, 48 hours, and 72 hours after operation, and their blood samples were collected 5 minutes before induction of anesthesia (T0), at the time of tracheal extubation (T1) and at postoperative 24 hours (T2), 48 hours (T3), and 72 hours (T4) to determine the concentrations of MMP-9 and ADP in their serums.
Results POD occurred in 19 patients, with the incidence rate of 17.8%. The concentrations of MMP-9 at T1 - T4 were significantly higher than those before lobectomy in serums in POD group, while the concentrations of ADP in serums were significantly lower than those before lobectomy (P < 0.05). The concentrations of MMP-9 in serums at T1 were significantly higher than those before lobectomy in non-POD group, while the concentrations of ADP in serums were significantly lower than those before lobectomy (P < 0.05). In the comparison between the two groups, the concentrations of MMP-9 in POD group at T1 - T4 were significantly higher than those in non-POD group, while the concentrations of ADP in POD group were significantly lower than those in non-POD group (P < 0.05).
Conclusion The serum level of MMP-9 is increased and ADP is decreased in perioperative, wich maybe involved in the pathophysiological process of POD in elderly patients undergoing lobectomy. |
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