血必净对中度贫血女性患者术后早期认知功能障碍的影响

目的:观察血必净注射液对中度贫血女性患者术后认知功能障碍(Postoperative Cognitive Function,POCD)的发生率的影响,并探讨其可能机制。方法:选取我院腹腔镜下子宫肌瘤剔除术或全子宫切除术的女性患者160例,随机分成中度贫血组(C组,80例)和血必净治疗组(X组,80例)。所有患者均采用相同的麻醉和复苏方案。其中,X组于麻醉诱导前及送麻醉复苏室(Postanesthesia Care Unit,PACU)后给予血必净注射液100 mL静脉滴注,C组给予同等体积的生理盐水静脉滴注。分析各组患者术前、术后1 d、7 d的蒙特利尔认知测试(Montreal Cognitive Assessment,MoCA)评分差异,计算POCD发生率,比较其术前及术后1 d的血清S-100β和IL-6水平变化。结果:各组患者一般情况以及术前MoCA评分均无明显差异。术后第1 d和第7 d,与C组相比,X组患者POCD发生率较低(P<0.05)。两组术前血清S-100β和IL-6水平均无差异。术后1 d,两组患者血清S-100β和IL-6水平均较术前升高。与C组相比,X组术后1 d血清S-100β和IL-6水平降低。结论:血必净注射液可通过调控术中炎症水平,减轻中枢神经损伤,降低中度贫血女性患者POCD发生率。

Effect of Xuebijing Injection on Postoperative Cognitive Dysfuntion in Female Patients with Moderate Anemia

Objective:To explore the effect of Xuebijing Injection on postoperative cognitive function(POCD)in female with moderate anemia.Methods:160 female patients with moderat anemia,who were undergoing laparoscopic total hysterectomy or laparoscopic myomectomy,were randomly divided into Group C(n=80)and Group X(n=80).Same anesthesia and recovery plan were performed in all patients.100 mL Xuebijing Injection was administrated to patients before anesthesia induction and right after being sent to Postanesthesia care unit in Group X while same volume of saline was given in Group C at the same time points.The score of Montreal Cognitive Assessment(MoCA)on the day before surgery,the day after surgery and 7 days after surgery were recorded,and rate of POCD in either group was calculated.Blood samples were collected on the day before surgery and the day after surgery for the determination of serum S-100βprotein and IL-6 concentrations.Results:No significant difference was found between groups in general information and the score of MoCA on the day before surgery.The incidence of POCD were lower in Group X compared with Group C on the day after surgery and the 7th day after surgery.Level of S-100βand IL-6 show no difference before surgery between groups.And there were a significant increase in both group of S-100βand IL-6 after surgery,in which,S-100βand IL-6 were much lower in Group X than Group C.Conclusion:Xuebijing Injection could reduce the incidence of POCD in female patients with moderate anemia by inhibiting the release of S-100βand IL-6.