Effects of dexmedetomidine on postoperative cognitive function and exosomal miR-29c expression in elderly patients undergoing spinal surgery
Objective To investigate the effects of dexmedetomidine(DEX)on the postoperative cognitive function and the expression level of exosomal miR-29c in elderly patients undergoing spinal surgery.Methods A total of 120 elderly patients undergoing elective orthopedic spine surgery in our hospital were divided into DEX group and control group according to the random number table method,with 60 cases in each group.The patients in DEX group were given 0.8 μg/(kg·h)DEX 10 min before anesthesia,and 0.5 μg/(kg·h)DEX by infusion pump during the operation until 30 min before the end of the operation.The patients in control group were infused with the same volume of normal saline.The incidence of postoperative cognitive dysfunction(POCD)and the expression levels of serum exosomal miR-29c,S100-βprotein and neuron-specific enolase(NSE)one day before surgery,one day and three days after surgery were compared between DEX group and control group.The patients were divided into POCD group and non-POCD group according to the Montreal cognitive assessment(MoCA)score one day before surgery and one day after surgery.The expression levels of serum exosomal miR-29c,S100-β protein and NSE were compared between POCD group and non-POCD group.Results The MoCA scores one day after surgery were lower than those one day before surgery in DEX group and control group(P＜0.05).Compared with control group,the MoCA score in DEX group was increased one day after surgery(P＜0.05).The incidence of POCD in DEX group was lower than that in control group(P＜0.05),and the relative expression levels of serum S100-β protein,NSE and miR-29c one day and three days after surgery were also lower in DEX group than in control group(P＜0.05).The expression levels of serum S100-β protein,NSE and miR-29c in POCD group were significantly higher than those in non-POCD group one day and three days after operation(P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that the AUCs of NSE,S100-β protein and exosomal miR-29c expression at postoperative one day in predicting the risk of postoperative cognitive dysfunction in elderly patients were 0.852,0.856 and 0.893,respectively.Conclusion DEX can reduce the risk of POCD and the serum level of exosomal miR-29c in elderly patients undergoing spinal surgery under general anesthesia.
万方数据
维普
