Expression significance of S100β,H-FABP,NLRP3 mRNA and caspase-1 mRNA in elderly patients with CD after intraspinal anesthesia
Objective To analyze the risk factors of cognitive dysfunction(CD)after intraspinal anesthesia in elderly patients with hip arthroplasty(THA)and predictive value of central nerve specific protein(S100-β),nucleotide binding oligonucleotide domain receptor protein 3 messenger RNA(NLRP3 mRNA),central fatty acid binding protein(H-FABP)and aspartate proteolytic enzyme 1 messenger RNA(caspase-1 mRNA).Methods 40 elderly THA patients who developed CD after spinal anesthesia were included in group A,and another 68 elderly THA patients who did not develop CD were selected for group B.The clinical data,S100-β,H-FABP,NLRP3 mRNA,and caspase-1 mRNA of the two groups were compared,and the risk fac-tors were analyzed through multifactor logistic regression analysis.The predictive value of S100-β,H-FABP,NLRP3mRNA,andcaspase-1mRNA on the occurrence of CD after intraspinal anesthesia in elderly patients with hip replacement was analyzed using receiver operating characteristic(ROC)curve.Results The age of group A was significantly longer than that of group B(t=13.674,P<0.05).The proportion of patients with diabetes and in-traoperative hypotension was also higher than that in group B(x2=12.643,17.767,P<0.05).The expression lev-els of serum S100-β,NLRP3mRNA,H-FABP,andcaspase-1mRNA in group A were significantly higher than those in group B(t=14.571,21.691,80.159,23.572,P<0.05).The independent risk factors for CD after spinal anesthesia in elderly patients undergoing THA included older age,diabetes mellitus,intraoperative hyposthenia,and high levels of serum S100-β,H-FABP,NLRP3mRNA,andcaspase-1mRNA(P<0.05).The combined de-tection of S100-β,H-FABP,NLRP3mRNA,andcaspase-1mRNA predicted an area under the curve(AUC)of 0.915 for CD occurrence after spinal anesthesia in elderly patients undergoing THA surgery,which was higher than with a single detection(P<0.05).Conclusion Old age,diabetes mellitus,and intraoperative hyposthenia were all independent risk factors for CD after intraspinal anesthesia in elderly patients with THA.The combined detection of S100-β,H-FABP,NLRP3 mRNA,and caspase-1 mRNA had a high predictive value for CD.
S100-βCentral nerve specific proteinNLRP3 mRNAcaspase-1
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