S100B蛋白测定在老年肺癌根治术后认知功能障碍评价中的临床价值研究中国人民解放军第一五三中心医院呼吸内科河南郑州450042【摘要】目的：为了了解SlOObeta;蛋白与术后认知功能的关系，探索血清SlOObeta;蛋白水平测定在老年肺癌根治术后认知功能障碍评价中的临床价值。方法：采用前瞻性研究方法，选取我院近年來肺癌择期手术患者80例作为手术组，及同期健康体检者80例作为对照组，分别测定两组研究对象术前24h及术后30min>6h>24h、72h>1周血清SlOObeta;蛋白水平，同时对两组研究对象作术前24h及术后6h、24h、72h、1周的MMSE评分，所得结果以均数plusmn;标准差表示，并应用统计学软件进行统计分析。结果：手术组术后30min>6h、24h、72h血浆SlOObeta;蛋白水平较术前及同期对照组明显升高(P《0.05),表明术后脑损伤的存在。两组MMSE评分比较，手术组术后6h、24h、72h的MMSE评分较术前及同期对照组值明显降低(P《0.05),反映手术组患者术后早期认知功能障碍的存在，且评分越低认知功能障碍越严重。结论：血清SlOObeta;蛋白水平可作为反映术后脑损伤的指标，且血清SlOObeta;蛋白浓度与损伤程度具有相关性，检测血清SlOObeta;蛋白水平有利于评价术后认知功能障碍的严重程度，能指导老年肺癌根治术患者术后早期的认知功能障碍治疗及判断预后。【关键词】老年；肺癌根治术后;SlOObeta;蛋白;认知功能障碍ClinicalValueofSlOObeta;proteindeterminationinevaluatingthecognitivedysfunctionofelderlylungcancerradicalpostoperativeYehe激ang(DepartmentofRespiratoryMedicine,ThePeople'sLiberationArmyfirstfifty-threeCentralHospital,Zhengzhou450042,China)[Abstract]Objective:TounderstandtherelationshipbetweenproteinandcognitivefunctioninpatientsSlOObeta;exploreSlOObeta;proteinserumlevelsweremeasuredinelderlylungcancerclinicalvalueassessmentofradicalpostoperativecognitivedysfunction.Methods:Aprospectivestudyoflungcancerpatientsinourhospitalinrecentyears,80casesofelectivesurgeryasthesurgeryoup,and80casesofhealthyvolunteersasacontrolgroup,twogroupsofsubjectsweremeasuredbeforesurgery24h,after30min,6h,24h,72h,lweekSlOObeta;serumproteinlevelsandbothgroupsbeforeandafter24h6h,24h,72h,1weekMMSEscore,themeasuredresultsareexpressedasmeanplusmn;standarddeviation,andusingstatisticalsoftwareforstatisticalanalysis.Results:surgerygroupafter30min,6h,24h,72hSlOObeta;plasmaproteinlevelscomparedwithpreoperativeandcon・currentcontrolgroupwassign讦icantlyhigher(P《0.05),describedthepreseneeofpostoperativebraindamage.MMSEscoresbetweenthetwogroupsoverthesameperiod,aftersurgery6h,before24h,72hMMSEscoreandthesameperiodcomparedwiththatinthecontrolgroupwassignificantlylower(P《0.05),earlypostoperativecognitivedysfunctionsurgerygroup,andscoremoreThemoreseverelowcognitivedysfunction.Conclusions:SerumSlOObeta;proteincanbeusedasanindicatorofthelevelofpostoperativebraininjury,serumproteinlevelsSlOObeta;tofacilitatetheevaluationofpostoperativecognitivedysfunctionseverity,canguidetheelderlylungcancerpatientsafterradicalsurgeryearlycognitivedysfunctiontreatmentandtheprognosis.【Keywords]elderly;lungcancerafterradical;SlOObeta;protein;cognitivedysfunction【】R614【文献标识码】A【】2096-0867(2016)-2-094-02近年来，虽然麻醉技术得到明显的提高和改善，但老年患者术后认知功能障碍的发牛率任然较高，尤其是经历大手术后，这种现象已越来越受到医护工作者的重视。自1998年一项对1218例实施非心脏手术的老年患者术后认知功能障碍的国际性研究(ISPOCDI)中，发现术后一周老年患者认知功能障碍的发生率为26%,术后3个月为10%[1]这一结果以来，术后认知功能障碍的研究已成为外科及麻醉科医护工作者的研究热点。老年患者因为年龄等因素，POCD的发牛率一直居高不下，这不仅延长老年患者的住...