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JAMA Neurol:麻醉、手术与中枢神经损伤

2018-02-23 zhangfan MedSci原创

神经原纤维素水平是轴索损伤的特异性标志,在许多神经元损伤疾病中均有高表达,而tau蛋白反映的是轴突完整性,其水平升高与中枢损伤相关。研究发现,在麻醉以及手术后48小时血液中的神经原纤维素及tau蛋白水平高于术前,表明全麻和手术在短期内与神经元损伤有关

麻醉和手术对中枢神经系统以及神经细胞损伤的影响、程度以及机制研究尚不充分。近年来,对神经系统后遗症的关注要求学术界重新审视麻醉和手术对中枢系统的影响。近日研究人员考察了手术及麻醉前后神经损伤标志物--神经原纤维素及tau蛋白水平的变化。

研究招募60岁以上接受全麻手术患者,采集患者手术前以及术后30分钟、6小时、24小时以及48小时血样。研究的主要终点是麻醉及手术导致的神经系统损伤。

30名患者参与研究,平均年龄69.1岁,女性占59%,73%的患者接受关节置换手术。研究发现患者术后神经原纤维素水平由基线时的22.3 pg/mL,上升至术后48小时的35.1pg/mL,涨幅达67%;tau蛋白水平由基线的3.1 pg/mL上升至术后6小时的10.8 pg/mL,涨幅为257%,tau蛋白水平在术后6小时达到峰值,其后降低但至术后48小时tau蛋白水平仍高于基线水平。

神经原纤维素水平是轴索损伤的特异性标志,在许多神经元损伤疾病中均有高表达,而tau蛋白反映的是轴突完整性,其水平升高与中枢损伤相关。研究发现,在麻醉以及手术后48小时血液中的神经原纤维素及tau蛋白水平高于术前,表明全麻和手术在短期内与神经元损伤有关。

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    2019-01-10 yinhl1978
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