右美托咪定对脑膜瘤患者血浆中脑源性神经生长因子和认知功能障碍的影响

目的探讨右美托咪定对脑膜瘤患者血浆中脑源性神经生长因子(BDNF)水平及认知功能障碍的影响。方法将120例脑膜瘤患者随机分为对照组(生理盐水)和观察组(右美托咪定),每组60例。比较2组拔管12 h(T₃)、拔管48 h(T 4)、拔管第3天(T₅)、拔管第7天(T₆)时的平均动脉压(MAP)、血氧饱和度(SpO₂)、心率(HR)、呼吸频率。统计2组插管30 min(T₂)、T₃、T₄、T₅、T₆时的BDNF变化情况。评估2组术前(T₁)、拔管第8天(T₇)、拔管第14天(T₈)、拔管第20天(T₉)、拔管第24天(T₁₀)、拔管1个月(T₁₁)时的认知功能变化。结果观察组T₃、T₄、T₅、T₆时MAP、HR低于对照组,差异均有统计学意义(P<0.05);与T 2比较,2组T₄、T₅时BDNF水平升高,差异均有统计学意义(P<0.05);观察组T₆时BDNF水平升高,且高于对照组,差异有统计学意义(P<0.05)。与T₁时比较,对照组T₇~T₁₁简易精神状态量表(MMSE)评分、蒙特利尔认知量表(MoCA)评分下降(P<0.05);观察组T₇~T₉时MMSE和MoCA评分下降,T₁₀、T₁₁时MMSE和MoCA评分上升,差异均有统计学意义(P<0.05)。观察组T₁₀、T₁₁时MMSE和MoCA评分均高于对照组,差异有统计学意义(P<0.05)。结论右美托咪定应用于神经外科镇静效果佳,可显著改善患者认知功能。

Effects of dexmedetomidine on plasma brain derived neurotrophic factor and cognitive dysfunction in patients with meningiomas

Objective To investigate the effect of dexmedetomidine on plasma levels of brain derived nerve growth factor(BDNF)and cognitive dysfunction in patients with meningioma.Methods A total of 120 patients with meningioma were randomly divided into control group(normal saline)and observation group(dexmedetomidine),with 60 cases in each group.Mean arterial pressure(MAP),blood oxygen saturation(SpO₂),heart rate(HR),and respiratory rate at 12 h(T₃),48 h(T₄),3 d(T₅)and 7 d(T₆)after extubation were compared between the two groups.BDNF changes at 30 min of intubation(T₂),T₃,T₄,T₅and T₆in the two groups were statistically analyzed.The cognitive function changes of the two groups were evaluated before operation(T₁),8 d(T 7),14 d(T₈),20 d(T⁹),24 d(T₁0),and 1 month(T₁1)of extubation.Results The MAP and HR in the observation group were significantly lower than those in the control group at T₃,T₄,T₅and T₆(P<0.05).Compared with T₂,BDNF levels were significantly increased at T₄and T₅in the two groups(P<0.05);the T₆BDNF level in the observation group was significantly increased,and was significantly higher than that in the control group(P<0.05).Compared with T₁,the Mini-Mental State Examination(MMSE)scores and Montreal Cognitive Assessment(MoCA)scores at time points from T₇to T₁1 in the control group were significantly decreased(P<0.05);the MMSE and MoCA scores significantly decreased at time points from T₇to T₉,and the MMSE as well as MOCA scores significantly increased at T₁0 and T₁1 in the observation group(P<0.05).The MMSE and MoCA scores at T₁0 and T₁1 of the observation group were significantly higher than those of the control group(P<0.05).Conclusion Dexmedetomidine has a good sedative effect in neurosurgery and can significantly improve the cognitive function of patients.