老年全身麻醉患者ADP和MMP-9的含量与术后认知功能障碍的相关性分析

【目的】探讨老年全身麻醉患者血液中基质金属蛋白酶‐9（MM P‐9）、脂联素（ADP）含量的变化与患者术后认知功能障碍（POCD）的相关性。【方法】本院接受手术治疗的老年患者64例根据其术后是否发生POCD 分为发生组和未发生组，比较两组患者手术前后血液中 ADP 和 MMP‐9含量的变化以及认知功能情况以及其相关性。【结果】64例患者中，发生 POCD 者12例，发生率为18．75％（12／64）；发生组和未发生组患者术前 ADP 和 MMP‐9水平相比较差异无显著性（ P ＞0．05）；手术后两组患者的 ADP 均较术前降低，MMP‐9均较术前增高（ P ＜0．05），且发生组的上述指标变化更明显（ P ＜0．05）。两组患者术前简易精神状态评定量表（MMSE）中的定向力、瞬时记忆、注意力和计算力等认知功能评分相比较差异无显著性（ P ＞0．05）；术后发生组患者的上述指标均较术前降低，而未发生组的上述指标较术前无明显改变；患者 ADP 与 MMSE 得分呈显著正相关，而 MMP‐9与 MMSE 得分呈显著负相关（均 P ＜0．05）。【结论】ADP 和 MMP‐9在老年全身麻醉术后出现 POCD 的患者中水平较高，可作为临床重要的监测指标。

Correlation Analysis between ADP and MMP-9 Levels in Blood and Postoperative Cognitive Dys-function in Elderly Patients Undergoing General Anesthesia

Objective] To observe the changes in ADP and MMP‐9 in the blood of elderly patients with general anesthesia and analyze the correlation between levels of ADP and MMP‐9and postoperative cognitive dysfunction .Methods]A total of 64 cases of elderly patients who received surgical treatment in our hospital were observed .According to the occurrence of cognitive dysfunction after operation ,they were divided into the occurrence group and the non‐occurrence group .The changes in ADP and MMP‐9 levels in blood before and af‐ter operation of patients in the two groups were observed and the cognitive function wasevaluated .The correla‐tion between the content of ADP and MMP‐9 in patients and postoperative cognitive dysfunction was analyzed .Results]Among the 64 patients ,12 patients experienced postoperative cognitive dysfunction ;the incidence was 18 .75% .The ADP and MMP‐9 levels of the two groups before operation showed no significant difference . The ADP levels in two groups were lower after operation than before operation .MMP‐9 levels were higher af‐ter surgery than before surgery ,and the change in the occurrence group was more obvious ( P < 0 .05) .The directional force ,instantaneous memory ,and attention calculation cognitive dysfunction of the two groups be‐fore surgery showed no significant difference .After surgery ,these variables in patients with cognitive impair‐ment compared with preoperative decreased .The above indexes of the non‐occurrence group showed no obvious changes compared to before surgery .ADP and MMSE scores were significantly positively correlated ,while MMP‐9 and MMSE scores were significantly negatively correlated ;the difference was statistically different ( P< 0 .05) .Conclusion]ADP and MM P‐9 in elderly patients with cognitive dysfunction is higher after general anesthesia ,which can be used as an important indicator of clinical monitoring .