Relationship between BCRP-BBB and dexmedetomidine-induced improvement in postoperative cognitive function in patients with mild hyperbilirubinemia
10.3760/cma.j.cn131073.20240312.00805
- VernacularTitle:BCRP-BBB与右美托咪定改善轻度高胆红素血症患者术后认知功能的关系
- Author:
Yi SUN
1
;
Haiyun WANG
;
Mingshu ZHAO
;
Qing LI
;
Yizhen WANG
Author Information
1. 天津医科大学三中心临床学院 天津市第三中心医院麻醉科 天津市重症疾病体外生命支持重点实验室 天津市人工细胞工程技术研究中心 天津市肝胆疾病研究所，天津 300170
- Keywords:
Dexmedetomidine;
ATP binding cassette transporter, subfamily G, member 2;
Blood-brain barrier;
Postoperative cognitive complications;
Hyperbilirubinemia;
C
- From:
Chinese Journal of Anesthesiology
2024;44(8):927-931
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the relationship between breast cancer resistance protein (BCRP)-blood brain barrier (BBB) and dexmedetomidine-induced improvement in postoperative cognitive function in patients with mild hyperbilirubinemia.Methods:This was a prospective study. Ninety patients of both sexes with mild hyperbilirubinemia caused by choledocholithiasis, aged 55-69 yr, with body mass index of 22-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, with preoperative Mini-Mental State Examination (MMSE) scores≥20, scheduled for elective cholecystectomy, exploratory choledocholithotomy and T-tube drainage from December 2022 to August 2023 in the Third Central Hospital of Tianjin, were divided into 2 groups( n=45 each) using a random number table method: control group (C group) and dexmedetomindine group (D group). After induction of anesthesia, dexmedetomidine was intravenously infused at a loading dose of 0.5 μg/kg over 10 min, followed by an infusion of 0.6 μg·kg -1·h -1 until the end of operation in group D, and the equal volume of normal saline was given instead in group C. At 2 days before operation and 1, 3, 5, 7 and 14 days after operation, the cognitive function was assessed using MMSE and Montreal Cognitive Assessment, and the serum BCRP concentration, concentrations of cognitive function serological indicators (serum S100β, β amyloid 42, malondialdehyde), and concentrations of BBB serological indicators (serum glial fibrillary acidic protein, thrombospondin 1, claudin 5) were determined using enzyme-linked immunosorbent assay. Results:Compared with group C, MMSE and Montreal Cognitive Assessment scores were significantly increased, the incidence of cognitive impairment was decreased, the serum concentrations of S100β, β amyloid 42 and malondialdehyde were decreased, the serum concentrations of BCRP were increased, and the serum concentrations of glial fibrillary acidic protein, claudin-5 and thrombospondin 1 were decreased in group D ( P<0.05). Conclusions:The mechanism by which dexmedetomidine improves postoperative cognitive function may be related to up-regulating BCRP levels and improving BBB function in patients with mild hyperbilirubinemia.
