Changes in perioperative plasma melatonin, cortisol and neuron-specific enolase and neuropsychological function in patients who develop CNS complication after coronary artery bypass
- VernacularTitle:冠状动脉搭桥术后中枢神经系统并发症病人围术期神经内分泌和术后神经心理的变化
- Author:
Yiqing YIN
;
Ailun LUO
;
Xiangyang GUO
- Publication Type:Journal Article
- Keywords:
Melatonin;
Hydrocortisone;
Phosphopyruvate hydratase;
Coronary artery bypass;
Neuropsychological tests;
Postoperative complications;
Central nervous system diseases
- From:
Chinese Journal of Anesthesiology
1994;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the changes in perioperative plasma melatonin, cortisol and neuron-specific enolase (NSE) and neuropsychological function in patients who developed CNS complications after coronary artery bypass grafting (CABG) .Methods Three patients developed CNS complications (cerebral infarction, motor aphasia, motor and sensory aphasia) after CABG performed under hypothermic cardiopulmonary bypass (CPB) were studied. Blood samples were taken before induction of anesthesia (T1) , 10 min after tracheal intubation (T2), 10 min after heparinization (T3), at 30 min of CPB (T4) , immediately after discontinuation of CPB (T5), at closure of chest (T6), immediately after returning to ICU (T7) and every 3 h in ICU for 24 h (T8-15) for determination of plasma concentrations of NSE, cortisol and melatonin using enzyme-linked immunosorbent assay and radioimmunoassay. Cognitive function was measured before and 10 to 20 days after operation using a battery of tests, while depression and anxiety were assessed by self-rating depression scale and state-trait anxiety inventory respectively. Results The plasma NSE concentration was increased after operation in all 3 patients. The circadian rhythms of melatonin and cortisol were disturbed in patient 1 and 2 during the 24h after operation but were retained in patient 3. In patient 1 and 3 the performance of the trailing making test, the digit symbol subtest of WAIS-R and the stroop color word interference test were poor, meanwhile they became more depressed and less anxious. Conclusion In patients who develop CNS complication after CABG, there are cognitive decline, sentimental disorders and disrupted circadian rhythm of melatonin and cortisol secretion.
