切换至 "中华医学电子期刊资源库"

中华普外科手术学杂志(电子版) ›› 2019, Vol. 13 ›› Issue (02) : 162 -165. doi: 10.3877/cma.j.issn.1674-3946.2019.02.017

所属专题: 文献

论著

结肠癌患者术后认知功能障碍与5-羟色胺受体3B亚基相关性及其对预后的影响
刘展,1, 李云涛1, 李世红1, 龙飞伍1, 任海亮1, 古建辉1   
  1. 1. 610031 成都,成都市第三人民医院普外科
  • 收稿日期:2018-06-17 出版日期:2019-04-26
  • 通信作者: 刘展

Correlation between cognitive dysfunction and 5-serotonin receptor 3B subunit in patients with colon cancer after curative resection and its effect on prognosis

Zhan Liu,1, Yuntao Li1, Shihong Li1, Feiwu Long1, Hailiang Ren1, Jianhui Gu1   

  1. 1. Chengdu Third People’s Hospital General Surgery, Sichuan Chengdu 610031
  • Received:2018-06-17 Published:2019-04-26
  • Corresponding author: Zhan Liu
  • About author:
    Corresponding author: Liu Zhan, Email:
  • Supported by:
    Department of health of Sichuan Provincial, scientific research project(No. 130420)
引用本文:

刘展, 李云涛, 李世红, 龙飞伍, 任海亮, 古建辉. 结肠癌患者术后认知功能障碍与5-羟色胺受体3B亚基相关性及其对预后的影响[J/OL]. 中华普外科手术学杂志(电子版), 2019, 13(02): 162-165.

Zhan Liu, Yuntao Li, Shihong Li, Feiwu Long, Hailiang Ren, Jianhui Gu. Correlation between cognitive dysfunction and 5-serotonin receptor 3B subunit in patients with colon cancer after curative resection and its effect on prognosis[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(02): 162-165.

目的

探讨结肠癌术后患者认知功能障碍与5-羟色胺受体3B亚基相关性及其对预后的影响。

方法

回顾性分析2013年5月至2017年1月86例均在全麻下行腹腔镜结肠癌切除术资料,根据患者术后是否存在认知功能障碍,将患者分为POCD组(认知功能障碍,n=28)和对照组(无认知功能障碍,n=58),采用SPSS22.0完成数据分析,两组患者心理健康状况等采用独立t检验;5-羟色胺受体3B亚基的基因多态性分析采用卡方检验,患者术后POCD的危险因素采用多因素logistics回归分析。P<0.05表示差异有统计学意义。

结果

两组患者rs10789970呈多态性分布,POCD组基因型主要表现为CC的野生型比例显著增高(P<0.05)。POCD患者rs10789970为CC、CT和TT的患者智能精神状态评价量表(MMSE)分别为(15.7±3.8)分、(17.8±3.8)分、(20.0±2.8)分(P=0.000)。多因素logistics回归分析显示rs10789970的野生型CC是结肠癌患者术后POCD发生的独立危险因素[1.21(1.02~1.40), P=0.002]。术前两组患者焦虑自我评分和抑郁自我评分均无统计学差异(P>0.05),与对照组比较,POCD组患者术后3 d时焦虑自我评分和抑郁自我评分均显著增高,术后肛门排气时间和住院时间均显著延长,差异均有统计学意义(P<0.05)。

结论

结肠癌患者术后认知功能障碍发生与rs10789970多态性分布有关,可恶化患者心理健康状况,影响术后康复。

Objective

To investigate the relationship between cognitive dysfunction and the 5-serotonin receptor 3B subunit in patients with colon cancer after curative resection and its effect on the prognosis.

Methods

From May 2013 to January 2017, 86 patients with colon cancer were retrospectively collected in our hospital. General anesthesia of laparoscopic surgery for colorectal cancer were preformed in all the patients. According to the presence of cognitive dysfunction in the patients after surgery, the patients were divided into a POCD group (cognitive dysfunction, n=28) and a control group (without cognitive impairment, n=58). The data analysis was completed by SPSS22.0. Independent t test was used in the two groups of patients’ mental health. The gene polymorphism analysis of 5-serotonin receptor 3B subunit was analyzed by chi square test. The risk factors of POCD in colon cancer patients after curative resection were analyzed by multiple factor logistic regression analysis. P<0.05 indicated that the difference was statistically significant.

Results

The polymorphic distribution of rs10789970 was found between the POCD group and the control group, and the proportion of the wild type CC in the POCD group was significantly higher than that of the control group (P<0.05). The MMSE of patients with POCD and CC, CT and TT of rs10789970 were 15.7±3.8、17.8±3.8 and 20.0±2.8, and the difference was statistically significant (P=0.000). Multiple factor logistic regression analysis showed that the wild type CC of rs10789970 was an independent risk factor for POCD in patients [1.21(1.02~1.40), P=0.002]. There were no significant difference in self-rating anxiety score and self-rating depression score between the two groups (P>0.05). When compared with the control group, the self-rating anxiety score and self-rating depression score in the POCD group were higher than that of the control group on the third day after the operation (P<0.05). When compared with the control group, the anal exhaust time and hospitalization time in the POCD group were significantly prolonged (P<0.05).

Conclusion

The occurrence of postoperative cognitive dysfunction in patients with colon cancer after curative resection is related to the polymorphism distribution of rs10789970, which can deteriorate the mental health of the patients and affect the postoperative rehabilitation.

表1 86例结肠癌患者术后POCD与否两组患者一般资料比较(例)
表2 86例结肠癌患者术后POCD与否两组5-羟色胺受体3B亚基的基因多态性分析(例)
表3 86例结肠癌患者术后POCD的危险因素分析
表4 86例结肠癌术后POCD与否两组患者心理健康状况[(±s),分]
表5 86例结肠癌术后POCD与否两组患者术后康复情况(±s)
表6 86例结肠癌术后POCD与否两组患者手术情况比较(±s)
[1]
Ratnapradipa KL, Lian M, Jeffe DB, et al. Patient, Hospital, and Geographic Disparities in Laparoscopic Surgery Use Among Surveillance, Epidemiology, and End Results-Medicare Patients With Colon Cancer[J]. Dis Colon Rectum,2017,60(9):905-913.
[2]
Garcia-Lopez S. Inflammatory bowel disease in Digestive Disease Week 2016: advances in epidemiology, follow-up, treatment monitoring, optimisation and individual tailoring, and colon cancer prevention[J]. Gastroenterol Hepatol,2016,39 (Suppl 1):29-35.
[3]
Wang R, Chen J, Wu G. Variable lung protective mechanical ventilation decreases incidence of postoperative delirium and cognitive dysfunction during open abdominal surgery[J]. Int J Clin Exp Med,2015,8(11):21208-21214.
[4]
Zheng XU, Ma Z, Gu X. Plasma levels of tumor necrosis factor-alpha in adolescent idiopathic scoliosis patients serve as a predictor for the incidence of early postoperative cognitive dysfunction following orthopedic surgery[J]. Exp Ther Med,2015,9(4):1443-1447.
[5]
Shoair OA, Grasso Ii MP, Lahaye LA, et al. Incidence and risk factors for postoperative cognitive dysfunction in older adults undergoing major noncardiac surgery: A prospective study[J]. J Anaesthesiol Clin Pharmacol,2015,31(1):30-36.
[6]
Biagi JJ, Raphael MJ, Mackillop WJ, et al. Association between time to initiation of adjuvant chemotherapy and survival in colorectal cancer: a systematic review and meta-analysis[J]. JAMA,2011,305(22):2335-2342.
[7]
Dos Santos LV, Faria TM, Lima AB, et al. Timing of adjuvant chemotherapy in colorectal cancer[J]. Colorectal Dis,2016,18(9):871-876.
[8]
Nachiappan S, Askari A, Mamidanna R, et al. The impact of adjuvant chemotherapy timing on overall survival following colorectal cancer resection[J].Eur J Surg Oncol,2015,41(12):1636-1644.
[9]
Livesey MR, Cooper MA, Lambert JJ, et al. Rings of charge within the extracellular vestibule influence ion permeation of the 5-HT3A receptor[J]. J Biol Chem,2011,286(18):16008-16017.
[10]
Yamada K, Hattori E, Iwayama Y, et al. Distinguishable haplotype blocks in the HTR3A and HTR3B region in the Japanese reveal evidence of association of HTR3B with female major depression[J]. Biol Psychiatry,2006,60(2):192-201.
[11]
Krzywkowski K, Davies PA, Feinberg-Zadek PL, et al.High-frequency HTR3B variant associated with major depression dramatically augments the signaling of the human 5-HT3AB receptor[J]. Proc Natl Acad Sci U S A,2008,105(2):722-727.
[12]
Silbert BS, Evered LA, Scott DA. Incidence of postoperative cognitive dysfunction after general or spinal anaesthesia for extracorporeal shock wave lithotripsy[J].Br J Anaesth,2014,113(5):784-791.
[13]
Wu C, Wang R, Li X, et al. Preoperative Serum MicroRNA-155 Expression Independently Predicts Postoperative Cognitive Dysfunction After Laparoscopic Surgery for Colon Cancer[J]. Med Sci Monit,2016,22(12):4503-4508.
[14]
Gupta M, Jain S, Moily NS, et al. Genetic studies indicate a potential target 5-HTR(3B) for drug therapy in schizophrenia patients[J].Am J Med Genet B Neuropsychiatr Genet,2012,159B(8):1006-1008.
[15]
Jian J, Li C, Xu J, et al. Associations of serotonin receptor gene HTR3A, HTR3B, and HTR3A haplotypes with bipolar disorder in Chinese patients[J].Genet Mol Res,2016,15(3):881-888.
[16]
Park HJ, Kang WS, Chung JH, et al. Association between promoter polymorphism (rs10789970) in 5-hydroxytryptamine receptor 3B and poor concentration in schizophrenia[J]. Psychiatry Res,2014,219(1):235-237.
[17]
简佳. HTR3A及HTR3B Tag SNP与中国汉族双相障碍及其认知功能的关联研究[D]. 济南:山东大学,2016.
[18]
乔冬冬.中国汉族人群HTR3B基因多态性与抑郁障碍及其认知功能的相关性研究[D].济南:山东大学,2015.
[19]
Gallegos AM, Streltzov NA, Stecker T. Improving Treatment Engagement for Returning Operation Enduring Freedom and Operation Iraqi Freedom Veterans With Posttraumatic Stress Disorder, Depression, and Suicidal Ideation[J]. J Nerv Ment Dis,2016,204(5):339-343.
[20]
Rogers CM, Mallinson T, Peppers D. High-intensity sports for posttraumatic stress disorder and depression: feasibility study of ocean therapy with veterans of Operation Enduring Freedom and Operation Iraqi Freedom[J]. Am J Occup Ther,2014,68(4):395-404.
[1] 孙俊锋, 涂家金, 付丹, 蒋满香, 刘金晶, 崔乃硕. 手部烧伤瘢痕挛缩畸形整形术后综合康复联合点阵二氧化碳激光治疗的临床效果[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(05): 411-415.
[2] 钟锴, 蒋铁民, 张瑞青, 吐尔干艾力·阿吉, 邵英梅, 郭强. 加速康复外科在肝囊型棘球蚴病肝切除术中的应用分析[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 425-429.
[3] 崔宏帅, 冯丽明, 东维玲, 韩博. 腹腔镜右半结肠癌D3根治术+IGLN清扫术治疗局部进展期结肠肝曲癌的临床效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 566-569.
[4] 丁志翔, 于鹏, 段绍斌. 血浆BRAF基因检测对腹腔镜右半结肠癌D3根治术中行幽门淋巴结清扫的指导价值[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 570-573.
[5] 王维花, 王楠, 乔庆, 罗红. 完全腹腔镜右半结肠癌切除术两种腔内消化道重建方案对比研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 574-577.
[6] 曹健, 冯高华, 周卫军, 陈诚, 沈王丰, 吴英姿. 补脾益肺膏联合肺康复训练治疗慢性阻塞性肺疾病的临床分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 781-784.
[7] 杨轲, 丁增巴姆, 马静, 李盼盼, 陈婷. 全程无缝隙肺康复训练在单孔胸腔镜肺叶切除术中的临床应用[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 801-804.
[8] 何慧玲, 鲁祖斌, 冯嘉莉, 梁声强. 术前外周血NLR和PLR对结肠癌术后肝转移的影响[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 682-687.
[9] 关国欣, 罗福文. 结肠癌合并急性梗阻的个性化处理[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 459-463.
[10] 石阳, 于剑锋, 曹可, 翟志伟, 叶春祥, 王振军, 韩加刚. 可扩张金属支架置入联合新辅助化疗治疗完全梗阻性左半结肠癌围手术期并发症分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 464-471.
[11] 陈冬冬, 余程冬, 曹晓光. 上肢外骨骼机器人在脑卒中康复中的应用与研究进展[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(05): 312-317.
[12] 谢浩文, 丁建英, 刘小霞, 冯毅, 姚婧. 椎旁神经阻滞对微创胃切除肥胖患者术中血流、术后应激及康复质量的影响[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 569-573.
[13] 贾玲玲, 滕飞, 常键, 黄福, 刘剑萍. 心肺康复在各种疾病中应用的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 859-862.
[14] 刘芳明, 石秀秀, 唐冲, 张克石, 徐影, 王桂杉, 关振鹏, 李晓. 骨科康复患者对数字疗法应用的知晓度和需求度:一项基于928 份问卷调查结果分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 654-661.
[15] 靳英, 付小霞, 陈美茹, 袁璐, 郝力瑶. CD147调控MAPK信号通路对结肠癌细胞增殖和凋亡的影响及机制研究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(05): 474-480.
阅读次数
全文
1
HTML PDF
最新录用 在线预览 正式出版 最新录用 在线预览 正式出版
0 0 0 0 0 1

  来源 其他网站
  次数 1
  比例 100%

摘要
29
最新录用 在线预览 正式出版
0 0 29
  来源 本网站 其他网站
  次数 12 17
  比例 41% 59%