高龄髋关节置换术后谵妄患者血清S-100β蛋白和NSE浓度的变化及临床意义

日的探讨高龄髋关节置换术后谵妄（PD）患者血清S-100p蛋白和NSE浓度的变化及临床意义．方法择期全身麻醉下髋关节置换术患者108例，ASAⅡ-Ⅲ，年龄75-93岁，体重40～75妇．采用精神紊乱评估法诊断PD，记录术后48h内PD的发生情况，根据术后48h是否持续发生谵妄分为谵妄组（PD组）和非谵妄组（NPD组），每组20例．于麻醉前（TO）、出术后恢复室前（T1）、术后24h（T2）和48h（T3）时取血样，测定人选患者血清S-100β蛋白和NSE的浓度．结果与T0时和NPD组比较，PD组T1-3时S-10013蛋白浓度升高（P〈0．05）；2组间各时点NSE浓度比较差异无统计学意义（P〉0．05）．结论血清S-100β蛋白浓度升高可预测高龄髋关节置换术后谵妄的发生，可作为早期诊断术后谵妄的生化指标．

Change and Significience of Plasma S-100 β Protein and NSE in Elderly Patients with Delirium after Hip Joint Replacement

Objective To explore the chang and clinical significance of serum S-100 J3 protein and Neuron specific enolase （NES） concentratons in elderly patients with delirium after hip joint replacement. Methods One hundred eight ASA Ⅱ-Ⅲ patients of both sexes, aged 75 - 93 years, weighing 40-75kg underwent hip joint replacement under general anesthesia. PD was diagnosed by the Confusion Assessment Method （CAM） . The incidence of PD was recorded within 48 h after operation. The patients were divided into 2 groups according to the occurrence of PD within 48 h after operation： PD group and NPD group （n=20 each） . Blood samples were taken at before anesthesia （TO）, durng their stay in PACU （T1）, and at 24 and 48 h after operation （T2 , T3） for determination of serum S-100 β protein and NSE eoncentratons. Results Compared with that at TO and in NPD Group , the serum S-100 β protein coneentraton was significantly increased in PD group （P〈0.05） , While NSE did not. Conclusions Increase of the serum S-100 β protein concentration can be used in predicting the development of PD in the elderly patients. The serum S-100 β protein concentraton can be used as a marker of PD patients.