摘要
目的 探讨全麻联合硬膜外麻醉对老年胫骨骨折患者Wnt/β-catenin信号表达水平的影响。方法 选择2018年1月至2020年12月中国中医科学院望京医院收治的80例胫骨骨折老年患者,按照麻醉方式将其分为对照组(静吸复合麻醉)和观察组(全麻联合硬膜外麻醉),每组均为40例。比较两组患者麻醉后Wnt/β-catenin信号表达水平,检测其术后认知功能评分及应激指标。结果 两组麻醉前Wnt、β-catenin、Tcf-4表达水平差异无统计学意义(t=0.784、0.000、-1.372,P均>0.05),麻醉后两组各指标均明显升高,且观察组低于对照组,差异有统计学意义(t=14.322、11.662、14.487,P均<0.05)。两组术前TNF-α、IL-6、MDA、SOD水平差异无统计学意义(t=0.108、0.141、0.359、0.130,P均>0.05)。术后3 d两组TNF-α、IL-6水平,差异无统计学意义(t=0.544、-0.147,P均>0.05),观察组MDA水平低于对照组,SOD水平高于对照组,差异有统计学意义(t=16.371、-6.661,P均<0.05)。术前1 d两组MMSE评分差异无统计学意义(t=0.434,P>0.05),术后1 d、3 d、7 d观察组MMSE评分高于对照组,差异有统计学意义(t=-9.098、-9.348、-11.482,P均<0.05)。结论 全麻联合硬膜外麻醉有助于抑制老年胫骨骨折患者Wnt/β-catenin信号表达及氧化应激反应,对其认知功能损伤程度较低,切实可行。
Objective To explore the effect of general anesthesia combined with epidural anesthesia on the expression of Wnt/β-catenin signal in elderly patients with tibial fracture. Methods Eighty elderly patients with tibial fracture who were admitted to our hospital from January 2018 to December 2020 were divided into a control group(static inhalation combined with anesthesia)and an observation group(general anesthesia combined with epidural anesthesia)according to the anesthesia method,40 cases in each group. The signal expression levels of Wnt/β-catenin after anesthesia were compared between the two groups,and the postoperative cognitive function score and stress index were detected. Results There was no significant difference in the expression levels of Wnt,β-catenin and Tcf-4 before anesthesia between the two groups(t=0.784,0.000,-1.372,P>0.05),and each indicator in the two groups was significantly increased after anesthesia,which was lower in the observation group than in the control group(t=14.322,11.662,14.487,P>0.05). There was no significant difference in levels of TNF-α,IL-6,MDA and SOD before operation between the two groups(t=0.108,0.141,0.359,0.130,P>0.05). There was no significant difference in levels of TNF-α and IL-6 of the two groups 3 d after operation(t=0.544,-0.147,P>0.05). The level of MDA in the observation group was lower than that in the control group,while the SOD level was higher than that in the control group,and the difference was statistically significant(t=16.371,-6.661,P>0.05). The difference in MMSE scores between the two groups was not statistically significant 1 d before operation(t=0.434,P>0.05),while the MMSE scores in the observation group were higher than those in the control group 1 d,3 d and 7 d after operation(t=-9.098,-9.348,-11.482,P>0.05). Conclusion General anesthesia combined with epidural anesthesia is effective and feasible in inhibiting oxidative stress in elderly patients with tibial fracture and impairing their cognitive function to a lesser extent.
作者
刘国胜
贾若
LIU Guosheng;JIA Ruo(Department of Anesthesiology,Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing,China,100102)
出处
《分子诊断与治疗杂志》
2022年第11期1922-1925,共4页
Journal of Molecular Diagnostics and Therapy
基金
北京市自然科学基金(7152143)。
作者简介
通信作者:贾若,E⁃mail:sjsdshici@yeah.net。
