Relationship between triggering receptor expressed on myeloid cells and postoperative cognitive dysfunction in elderly patients
10.3760/cma.j.issn.0254-1416.2018.12.004
- VernacularTitle:髓样细胞触发受体与老年患者术后认知功能障碍的关系
- Author:
Jinling ZHANG
1
;
Bin WANG
;
Xiaopeng SUN
;
Mingshan WANG
;
Xiaona XU
;
Yanlin BI
Author Information
1. 266071,青岛大学附属青岛市市立医院麻醉科
- Keywords:
Aged;
Congnition disorders;
Myeloid cells;
Receptors,immunologic
- From:
Chinese Journal of Anesthesiology
2018;38(12):1421-1425
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the relationship between the triggering receptor expressed on myeloid cells (TREM) and postoperative cognitive dysfunction (POCD) in elderly patients.Methods Eighty American Society of Anesthesiologists physical status Ⅰ-Ⅲ patients,aged 65-85 yr,weighing 50-80 kg,scheduled for elective total knee replacement under spinal-epidural anesthesia were enrolled in this study.Cerebrospinal fluid (CSF) was extracted after a catheter was successfully inserted into subarachnoid space.Blood samples from the cubital vein was collected before anesthesia induction (T0) and at 24 and 72 h after surgery (T1,2).The concentrations of TREM1 and TREM2 in CSF and plasma and tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) in plasma were measured by enzyme-linked immunosorbent assay.The expression of TREM1,TREM2,IL-6 and TNF-α protein and mRNA in mononuclear ceils in peripheral blood was detected using real-time polymerase chain reaction.Neuropsychological test was performed in the the same time period at 1 day before surgery and 7 days after surgery,and the Z score was used to diagnose the development of POCD.The patients were divided into POCD group (P group) and non-POCD group (NP group) according to whether or not POCD happened after surgery.Results The incidence of POCD was 22％.Compared with group NP,the plasma TREM1 concentrations at T1,2 and plasma IL-6 and TNF-α concentrations at T2 were significantly increased,and the expression of TREM1 mRNA and TNF-α mRNA at T1,2 and IL-6 mRNA at T2 was up-regulated in group P (P＜0.05).There was no significant difference in plasma TREM2 concentrations at each time point between and within groups (P＞0.05).There was a higher consistency between plasma and CSF TREM1 concentrations (Cronbach's Alpha=0.784,P＜ 0.01) and a high consistency between plasma and CSF TREM2 (Cronbach's Alpha =0.935,P＜0.01).Conclusion Up-regulated expression of central and peripheral TREM1 is related to the development of POCD in elderly patients.
