血清pNF-H、NSE、ESR与老年脊柱手术患者病情和术后认知功能的相关性研究

摘要 目的：研究老年脊柱手术患者血清神经丝蛋白H磷酸化亚型（pNF-H）、神经元特异性烯醇化酶（NSE）以及红细胞沉降率（ESR）水平与患者病情以及术后认知功能障碍发生的相关性。方法：选取2017年6月到2021年6月在我院进行脊柱手术的老年患者82例，根据病情严重程度分为脊髓未损伤组（n=35）、脊髓不完全损伤组（n=27）和脊髓完全损伤组（n=20），根据术后是否发生认知功能障碍（POCD）分为认知功能障碍组（POCD组，n=30）和无认知功能障碍组（No-POCD组，n=52）。比较各组患者术前和术后1天、3天、7天血清pNF-H、NSE和ESR水平。结果：（1）脊髓未完全损伤组患者血清pNF-H、NSE和ESR均显著高于脊髓未损伤组患者，而均显著低于脊髓完全损伤组患者（P<0.05）；（2）No-POCD组和POCD组在性别、年龄、体重、BMI、手术时间以及术中失血量均具有可比性（P>0.05）；（3）POCD组患者术前和术后1天、3天、7天血清pNF-H、NSE和ESR水平均显著高于No-POCD组患者（P<0.05）。结论：老年脊柱手术患者血清pNF-H、NSE和ESR水平与患者病情以及术后认知功能障碍发生有关，术前及术后血清pNF-H、NSE和ESR水平升高可能增加老年脊柱手术患者术后认知功能障碍风险，检测血清pNF-H、NSE和ESR水平有助于评估老年手术患者病情和术后认知功能障碍发生风险。

Correlation between Serum pNF-H, NSE, ESR and the Condition and Postoperative Cognitive Dyfunction of Elderly Patients Undergoing Spinal Surgery

ABSTRACT Objective: To study the relationship between serum neurofilament protein H phosphorylation subtype (pNF-H), neuron-specific enolase (NSE) and erythrocyte sedimentation rate (ESR) levels in elderly patients with spinal surgery and the occurrence of postoperative cognitive dysfunction. Methods: We selected 82 elderly patients who underwent spinal surgery in our hospital from June 2017 to June 2021. According to the severity of the disease, they were divided into a spinal cord injury group (n=35), a spinal cord injury group (n=27) and Complete spinal cord injury group (n=20). According to whether cognitive dysfunction (POCD) occurred after operation, they were divided into cognitive dysfunction group (POCD group, n=30) and no cognitive dysfunction group (No-POCD group, n=30). The serum levels of pNF-H, NSE and ESR were compared before and after 1 day, 3 days and 7 days after operation. Results: (1) The serum pNF-H, NSE and ESR of patients in the incomplete spinal cord injury group were higher than those in the incomplete spinal cord injury group, while were lower than those in the complete spinal cord injury group (P<0.05); (2) No-POCD group and POCD group are comparable in gender, age, weight, BMI, operation time and intraoperative blood loss (P>0.05); (3) Serum pNF-H, NSE and ESR levels in POCD group patients before and 1 day, 3 days and 7 days after operation were higher than those in the No-POCD group. Conclusion: Serum pNF-H, NSE and ESR levels in elderly patients undergoing spinal surgery are related to the patient''s condition and the occurrence of postoperative cognitive dysfunction. Elevated levels of serum pNF-H, NSE and ESR before and after surgery may increase the risk of cognitive dysfunction in elderly patients undergoing spinal surgery, and the detection of serum pNF-H, NSE and ESR levels can help assess the condition of elderly patients with surgery and the risk of postoperative cognitive dysfunction.