| ObjectiveTo evaluate the cognitive function of patients after general anesthesia.To detect serum?-amyloid protein(a ?)and peripheral blood ? 1-chymotrypsin(ACT).To explore the relationship between the changes of serum a?,act and postoperative cognitive dysfunction(POCD)in patients with general anesthesia.To find out the biological index of POCD and provide reference for clinical anesthesia.To provide guidance for the occurrence and development of POCD in the future,reduce the incidence of POCD,reduce the complications of patients and the burden of their families,and improve the quality of life of patients.MethodsFrom January 2018 to December 2019,80 patients with general surgery under general anesthesia were selected.The patients were given a set of neuropsychological tests(BCAI)one day before and seven days after operation.The patients were classified into POCD group and non POCD group according to whether POCD occurred or not.These patients had venous blood samples taken preoperatively,postoperatively and 7d postoperatively.Serum A?,ACT expression levels in patients were determined by ELISA.The correlation between A? and ACT levels was analyzed by Person and the relationship between changes in serum A? and ACT expression levels and POCD.Results1.The POCD occurred in 25 cases at 7d postoperatively with an incidence of31.25%,and 55 cases in the non-POCD group.There was no statistical difference in sex composition,age,height,weight,education level,duration of surgery and MMSE scorebetween POCD and non-POCD patients.(P>0.05).2.The POCD group was significantly lower in auditory vocabulary,verbal ability,classification,motor test,cancellation test,spatial structure,vocabulary recall and visual recognition scores at 7d postoperatively than at 1d preoperatively,but significantly higher in numerical linkage scores,with a statistically significant comparison difference(P<0.001)The non-POCD group was significantly lower in auditory vocabulary,cancellation test,speech ability and visual recognition scores at 7d postoperatively and significantly higher in digital linkage scores at 1d preoperatively,with a statistically significant comparison difference.(P < 0.001).No statistically significant differences in classification,motor tests,lexical recall,and comparative spatial structure in the non-POCD group(P>0.05).3.By repeated-measures data ANOVA,our results found statistically significant differences in ACT and A? levels across time,between groups,and with time interactions(P<0.05).No statistically significant difference in preoperative ACT and A? levels between the two groups of patients(P>0.05).The ACT and A? levels were significantly higher in both groups in the immediate postoperative period and at 7 d postoperatively than in the same group before(P<0.001).The ACT levels tend to increase with increasing postoperative time.ACT levels in the POCD group were significantly higher in the immediate postoperative period and 7 d postoperatively than in the non-POCD group(P<0.001).The POCD group had significantly higher postoperative 7d A? levels than cohort immediately after surgery,whereas non-POCD group had significantly lower postoperative 7d A? levels than cohort immediately after surgery(P<0.001).The A? levels in the POCD group were significantly higher in the immediate postoperative period and at7 d postoperatively than in the non-POCD group(P<0.001).The results of Pearson analysis showed that serum A? levels were significantly positively correlated with peripheral blood ACT levels immediately after surgery,with a correlation coefficient of 0.513.Also highly correlated at 7d postoperatively with a correlation coefficient of 0.902,P < 0.001.ConclusionHigh expression of A? levels in postoperative serum and ACT levels in peripheral blood in patients under general anesthesia,which may be among the biochemical markers of clinical POCD occurrence sensitivity.They serve as a basis for the prevention and development of POCD and for early integrated management. |
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