华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

β淀粉样蛋白1-40与老年患者颌面外科手术后并发谵妄的关系

郁葱1 张青1 陈思路1 罗玉琳1 肖水生2   

  1. 1.重庆医科大学附属口腔医院麻醉科; 2.颌面外科, 重庆400015
  • 收稿日期:2010-10-25 修回日期:2010-10-25 出版日期:2010-10-20 发布日期:2010-10-20
  • 通讯作者: 郁葱,Tel:13996202110
  • 作者简介:郁葱(1976—),男,重庆人,主治医师,硕士
  • 基金资助:

    重庆医科大学校级科研基金资助项目(XBYB2008055);重庆市教委科研基金资助项目(KJ080308)

Relationship between beta amyloid protein 1 -40 and post -operative delirium after oral and maxillofacial surgery in elderly patients

YU Cong1, ZHANG Qing1, CHEN Si-lu1, LUO Yu-lin1, XIAO Shui-sheng2   

  1. 1. Dept. of Anesthesiology, The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing 400015, China; 2. Dept. of Oral and Maxillofacial Surgery, The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing 400015, China
  • Received:2010-10-25 Revised:2010-10-25 Online:2010-10-20 Published:2010-10-20
  • Contact: YU Cong,Tel:13996202110

摘要:

目的观察老年颌面外科手术患者全身麻醉后术后谵妄(PD)的患病率,研究血浆β淀粉样蛋白1-40(Aβ1-40)与PD的关系。方法选择50例颌面外科手术患者,按照年龄分为T组(30例,年龄62~78岁)和C组(20例,年龄20~60岁),2组均采用静吸复合麻醉,以谵妄评定量表1998年修订版(DRS-R-98)来诊断和评估PD发生状况,记录术前(T0),术后24 h(T1)、48 h(T2)、72 h(T3)、96 h(T4)的DRS-R-98评分;并测定Aβ1-40质量浓度。结果T组患者PD的患病率为20.0%。T组Aβ1-40质量浓度在T0、T1、T2、T3时段明显高于C组(P<0.01),T组和C组Aβ1-40质量浓度在T1和T2时段明显高于同组T0时段(P<0.05)。T组在T3和T4时段的DRS-R-98评分明显高于同组T1时段和C组(P<0.01)。结论Aβ1-40在全身麻醉后持续升高可能是老年患者发生PD的重要原因之一。

关键词: 谵妄, β淀粉样蛋白1-40, 谵妄评定量表修订版

Abstract:

Objective To determine the incidence of post-operative delirium after oral and maxillofacial surgery under general anesthesia in elderly patients, and to examine its association with plasma concentrations of beta amyloid protein 1-40(Aβ1-40). Methods Fifty patients underwent elective oral and maxillofacial surgery were divided into two groups: Group C(n=20) aged from 20 to 60 years old, and Group T(n=30) aged from 62 to 78 years old. The two group received the same general anesthesia. Delirium rating scale-revised-98(DRS-R-98) was used as an instrument to diagnose and access the postoperative delirium of the two groups. The scores of DRS-R-98 were recorded before operation(T0) and at 24 h(T1), 48 h(T2), 72 h(T3) and 96 h(T4) after the operation. Serial measurements of serum concentrations of Aβ1-40 were also performed at the same time. Results The incidence of post -operative delirium after oral and maxillofacial surgery in Group T was 20.0%. The concentrations of plasma Aβ1-40 in group T were much higher than group C at T0, T1, T2 and T3 significantly(P<0.01). The concentrations of plasma Aβ1-40 at T1 and T2 were higher than those at T0 in the same group(P<0.05). The scores of DRS-R-98 in Group T at T3 and T4 were much higher than those at T1 and Group C significantly(P<0.01). Conclusion The constant increase of plasma Aβ1-40 may be one of the important factors related to post-operative delirium in elderly patients underwent oral and maxillofacial surgery.

Key words: delirium, beta amyloid protein 1-40, delirium rating scale-revised-98