盐酸戊乙奎醚复合乌司他丁对行开胸术患者术后认知功能的影响及机制研究

目的 探讨盐酸戊乙奎醚复合乌司他丁对行开胸术患者术后认知功能的影响.方法 将120例行开胸肺癌根治术患者分为盐酸戊乙奎醚复合乌司他丁组(HU组)、盐酸戊乙奎醚组(H组)、乌司他丁组(U组)和对照组(C组).采集动脉血检测氧合指数(OI)、肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6和IL-8,检测血清中S-100β和神经元特异性烯醇化酶(NSE)水平,评估简易精神状态评价量表(MMSE)评分.结果 与H组和U组相比,HU组T3～4时TNF-α均降低,T2～4时IL-6和IL-8均降低,而OI升高(P＜0.05);与H组和U组相比,HU组患者T5～8时血清S-100β和NSE水平均降低(P＜0.05);与H组和U组相比,HU组患者T6～7时MMSE评分升高(P＜0.05).结论 盐酸戊乙奎醚复合乌司他丁可减轻开胸术单肺通气时炎症反应,改善术后认知功能.

Effects and mechanism of penehyclidine hydrochloride combined with ulinastatin onpostoperative cognitive function in patients undergoing thoracic surgery

Objective To investigate the effects of penehyclidine hydrochloride combined with ulinastatin on postoperative cognitive function in the patients undergoing thoracic surgery.Methods One hundred and twenty patients undergoing lung cancer thoracotomic radical resection were randomly divided into hydrochloride penehyclidine composite ulinastatin group(HU group),hydrochloride penehyclidine group(H group),ulinastatin group(U group)and control group(C group).The arterial blood was collected for detecting OI,TNF-α,IL-6 and IL-8.The serum levels of S-100β and NSE were detected.The MMSE scores were evaluated.Results Compared with the H group and U group,the levels of TNF-α at T3-4 in the HU group were decreased,and the levels of IL-6 and IL-8 at T2-4 were decreased,while OI was increased(P＜0.05).Compared with the H group and U group,the serum levels of S-100β and NSE at T5-8 in the HU group were decreased(P＜0.05);compared with the H group and U group,the MMSE scores at T6-7 in the HU group were increased(P＜0.05).Conclusion Penehyclidine hydrochloride combined with ulinastatin could reduce the inflammation reaction during one lung ventilation in thoractomy and improves the postoperative cognitive function.