高级检索
    程丹, 庞雪, 马红霞, 张宏经, 许会贤, 颜明. 右美托咪定对老年髋关节置换患者认知功能及BDNF/TrkB信号通路的影响[J]. 徐州医科大学学报, 2018, 38(10): 684-687.
    引用本文: 程丹, 庞雪, 马红霞, 张宏经, 许会贤, 颜明. 右美托咪定对老年髋关节置换患者认知功能及BDNF/TrkB信号通路的影响[J]. 徐州医科大学学报, 2018, 38(10): 684-687.
    /B-[J]. Journal of Xuzhou Medical University, 2018, 38(10): 684-687.
    Citation: /B-[J]. Journal of Xuzhou Medical University, 2018, 38(10): 684-687.

    右美托咪定对老年髋关节置换患者认知功能及BDNF/TrkB信号通路的影响

    /B-

    • 摘要: 目的 观察右美托咪定(DEX)对老年髋关节置换患者认知功能及脑源性神经营养因子(brain-derived neurotrophic factor ,BDNF)和其受体酪氨酸受体激酶受体B (BDNF/TrkB)信号通路的影响。方法 选择老年髋关节置换患者60名,按随机数字表法分为3组,DEX低剂量组(A组)、DEX高剂量组(B组)和对照组(C组)。麻醉诱导前,A、B两组给予DEX负荷剂量0.5μg/kg,设定微量泵10分钟输注完成,C组微量泵输注相同容积生理盐水。麻醉诱导后:A组微量泵持续输注DEX 0.25μg/(kg·h);B组微量泵持续输注DEX 0.5μg/(kg·h);C组微量泵持续输注相同容积生理盐水,所有患者均泵注1h后停药。分别在DEX输注前(T1)、输注后(T2)、术后1d(T3),取患者中心静脉血检测BDNF/TrkB的含量;于T1及T2时间点采取桡动脉血和颈内静脉球部血样,进行血气分析,据此计算出Da—jv02和CERO2。盲法记录患者术前1天、术后7天MMSE评分。结果 与C组比,A、B两组T2及T3时间点BDNF/TrkB均表达增加 (P < 0.05);与A组比,B组T2及T3时间点BDNF、TrkB表达增加 (P < 0.05);与C组比,A、B两组T2时间点Da-jv02和CERO2降低 (P < 0.05);与C组比,A、B两组术后7天MMSE评分增加 (P < 0.05)。结论 DEX 可以减少老年髋关节置换患者围术期POCD的发生率,其机制可能与降低术中Da-jv02和CERO2,增加BDNF/TrkB的表达有关。

       

      Abstract: Objective To observe the influence of dexmedetomidine (DEX) on postoperative cognitive function and BDNF/TrkB signaling pathway in elderly patients undergoing total hip replacement . Methods Sixty patients over age 60 were randomly divided into three groups, DEX low dose group (A), DEX high dose group (B) and control group (C). Patients in A and B were loaded 0.5 μg DEX in 10 min, and C were loaded saline prior to anaesthesia. After induction of anesthesia, patients in A and B were injected 0.25μg/(kg?h) and 0.5μg/(kg?h) DEX, respectively, C were injected saline , all patients injected an hour.The vein blood were collected before DEX injection (T1), one hour injected (T2), and one day (T3) after operation to detect BDNF/ TrkB. The blood samples of the radial artery and the internal jugular vein were collected, and the blood gas analysis was performed to calculate the Da - jv02 and CERO2. The MMSE score were recorded at one day before operation and seven days after operation. Results The BDNF and TrkB expression in A group and B group was higher than C group at T2 and T3 (P < 0.05). moreover, the BDNF and TrkB expression in B group was higher than A group at T2 and T3 (P < 0.05). The Da-jv02 and CERO2 were lower at T2 in A group and B group compared to C group (P < 0.05) , and the MMSE in A group and B group was increased compared to C group. Conclusion The DEX could reduce the rate of POCD in elderly patients undergoing total hip replacement, and the reason might related to reduction of Da-jv02 and CERO2 and increasing expression of BDNF and TrkB

       

    /

    返回文章
    返回