Correlationship Between Postoperative Cognitive Dysfunction And The Serum Levels Of H-FABP And B-FABP In Elderly Patients With Spinal Surgery

Background:To investigate the changes of serum H-FABP and B-FABP levels aftersurgery in elderly patients undergoing spinal operation,and their relationship of them with incident of postoperative cognitive dysfunction（POCD）.Methods:A total of 78 elderly patients（older than 60 years）undergoing spinal surgery were assigned to the study.The invasiveartery blood pressure（IABP）and ECG were monitored continuously,and the changing levels of IABP were maintained nomore than 30%of the baseline.The partial pressure offend-tidal carbon dioxide was monitored and maintained at 35-45mmHg.The anesthesia depth was monitored with bispectral indexand the bisspectral indexvalues（BIS）maintained at40-60.Mini-mental State Examination（MMSE）scores were evaluated at 1d before surgery,1^std,3^rdd,5^thd after surgery.The serum levels of heart fatty acid binding protein（H-FABP）and brain fatty acid binding protein（B-FABP）were detected before and after surgery with enzyme-linked immune sorbent assay（ELISA）.Results:The hemodynamics of the patients was stable during the surgery.5 days after surgery,the overall incidence of POCD was 25.6%,the incidence of POCD occurred at the 1^stt day,3^rdday and 5^th day postsurgery was 19.2%,17.9%,16.7%respectively.The age of the patients with POCD was significantiy older than those without POCD（NPOCD）,and the incidence of POCD was positively correlated with age（R=0.244,P<0.05）.Compared with group NPOCD,the serum levels of H-FABP at 6h,and B-FABPat 24h postsurgery in group POCD increased more signiticantly,The increased levels of H-FABP and B-FABP were positively correlated with the incidence of POCD（R=0.866,P<0.01,R=0.559,P<0.01）.The area under the receiver operator characteristic curve（AUROC）for the H-FABP was 0.778,and the best cut-off value of the H-FABP for predicting POCD was 398.45ng/L（100%sensitivity and 55%specifcity）.The AUROC for the B-FABP was 0.842,and the best cut-off value of the B-FABP for predicting POCD was 152.58ng/L（80%sensitivity and 90%specifcity）.Conclution:The increased serum levels of H-FABP and B-FABP were positively correlated with the incidence of POCD in elder patients undergone spinal surgery.B-FABP has a better predictive power for the incidence of POCD than H-FABP.Serum levels of B-FABP more than≥152.58ng/L is closely related to the occurrence of POCD.