血浆稳态氧化氮产物和β淀粉样蛋白40.docVIP

β淀粉样蛋白1-40与老年颌面外科手术后谵妄的关系 (郁葱1，张青1，陈思路1，肖水生2（重庆医科大学附属口腔医院 ：1麻醉科；2颌面外科，重庆400015） 摘要：目的 观察老年颌面外科手术患者全身麻醉后谵妄( PD) 的发病率,研究血浆β淀粉样蛋白1-40与PD的关系。 选择50例颌面外科手术病人，按照年龄分为老年组（≥60岁）和中青年组（＜60岁），两组均采用静吸复合麻醉，以谵妄评定量表修订版(Delirium Rating Scale R-98 DRS-R-98)诊断和评估术后谵妄，记录术前（T0）、术后24h（T1）、48h（T2）、72h（T3）以及96h（T4）的谵妄等级评分(DRS-R-98)；并测定血浆β淀粉样蛋白1-40浓度。Aβ1-40浓度T组在T0、T1、T2、T3时段明显高于C组（P＜0.01），T组在T1和T2时段明显高于同组T0（P＜0.05）；C组在T1和T2时段明显高于同组T0（P＜0.05）。T组在术后72h（T3）和96h（T4）DRS-R-98评分显著高于同组术后24h（T0）和C组（P＜0.01）。 血浆β淀粉样蛋白1-40在全身麻醉后持续升高可能是老年病人发生术后谵妄的原因，谵妄评定量表修订版是诊断和评估手术后谵妄的有效工具。 关键词：手术后谵妄; β淀粉样蛋白1-40;谵妄评估量表修订版 R654.2 文献标识码：A Relationship between beta amyloid protein 1-40 and postoperative delirium after oral-maxilloficial surgery in elderly patients YU Cong1, XIAO Shui-sheng2，ZHANG Qing1,CHEN Si-lu.(1.Deptartment of Anesthesiology;2.Deptartment of Oral and Maxillofacial Surgery, The Stomatology Hospital of Chongqing Medical University ,Chongqing 400015 China) Abstract: Objective To determine the incidence of postoperative delirium (PD) after oral and maxillofacial surgery under general anesthesia in old patients and to examine its association with plasma concentrations of beta amyloid protein 1-40.Methods Sixty patients underwent elective oral-maxilloficial surgery were devided into two groups of younger group(Group C n=20) aged from 20 to 60 years old and older group (Group T n=40)older than 60 years.The two group were received the same general anesthesia methods. Delirium Rating Scale-Revised-98(DRS-R-98) was used as an instrument to diagnose and access the postoperative delirium.The score of DRS-R-98 was recorded before operation (T0）,at 24h（T1）,48h（T2）,72h（T3）and 96h（T4） postoperation. Serial measurements of serum concentrations of beta amyloid protein 1-40 were also performed at the same time.Results The concentration of plasma Aβ1-40 in group T was much higher than group C at T0、T1、T2 and T3 significantly（P＜0.01）and at T1 and T2 was higher than at T0 in the same group（P＜0.05）.ho