| 摘要: |
| 目的探讨老年髋关节置换术患者术后认知功能障碍（POCD）与血清缺氧诱导因子-1α（HIF-1α）水平的关系。方法选取80例老年患者在椎管内麻醉下行人工髋关节置换术，分别于手术前1d、术后6h及1、3、7d检测外周血清HIF-1α水平，采用简易智力状态检查量表（MMSE）评估认知功能，根据术后第3天MMSE评估结果将患者分为POCD组（P组）和非POCD组（NP组）进行分析。结果术后发生POCD患者共19例。两组患者术前1d血清HIF-1α水平和MMSE评分比较差异均无统计学意义（均P＞0.05）；与术前1d相比，P组术后6h及1、3、7d血清HIF-1α水平均明显升高，MMSE评分降低（均P＜0.05）；NP组术后6h及1d血清HIF-1α水平升高，MMSE评分下降（P＜0.05），但术后3、7d血清HIF-1α水平和MMSE评分渐恢复至术前水平（P＞0.05）；与NP组相比，P组术后6h及1、3、7d血清HIF-1α水平升高，MMSE评分均明显下降（均P＜0.05）；HIF-1α水平与MMSE评分均呈负相关（均P＜0.05）。结论老年髋关节置换术后POCD的发生可能与血清HIF-1α水平升高有关。 |
| 关键词: 缺氧诱导因子 -1α 手术后并发症 认知障碍 髋关节置换术 |
| DOI：10.12056/j.issn.1006-2785.2018.40.1.2017-269 |
| 分类号: |
| 基金项目:宁波市科技项目（2017A610221） |
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| Relationship between cognitive dysfunction and serum HIF-1α levels in elderly patients after hip replacement |
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Ningbo First Municipal hospital
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| Abstract: |
| Objective To investigate the relationship between post-operative cognitive dysfunction (POCD) and serum HIF-1α levels in elderly patients after hip replacement. Methods Eighty elderly patients with hip fractures received hip replacement under spinal anesthesia. The serum HIF-1α levels were measured at 1d before and 6h, 1d, 3d, 7d after surgery. The cognitive functions were evaluated using the minimental state examination(MMSE) after surgery, and the patients were divided into a POCD group (P group) and non-POCD group (NP group) according to their MMSE results. Results POCD occurred in 19 patients (23.7%). No statistically significant difference in serum HIF-1α levels at 1d before operation was observed between two
groups. The HIF-1α levels in P group increased and MMSE scores decreased significantly at 6h, 1d, 3d and 7d after surgery(P＜ 0.05), but in NP group the HIF-1α levels increased and MMSE scores decreased only at 6 h and 1 d after surgery, the levels returned to normal at 3d and 7d after surgery. The HIF-1α levels in P group were higher and MMSE scores were lower than those in NP group at all time points after surgery. The HIF-1α levels were negatively correlated with MMSE scores (r=-0.678, -0.632,
-0.598 and -0.545, respectively, all P＜0.05 ) at all postoperative time points. Conclusion Postoperative cognition dysfunction in elderly patients after hip replacement may be related to the increase of serum HIF-1α levels. |
| Key words: Hypoxia inducible factor -1α Postoperative complications Cognition disorders Ａrthroplasty, replace- ment, hip |
