Objective: To investigate the effects of dexmedetomidine(DEX) on postoperative cognitive function, plasma microRNA-206(miR-206) and brain derived neurotrophic factor(BDNF) levels in elderly patients with colorectal cancer. Methods: One hundred and sixty elderly patients undergoing elective colorectal cancer surgery under general anesthesia in our hospital from January 2018 to December 2019 were selected. The patients were divided into study group and control group according to the random number table method, with 80 patients in each. Patients in the study group were given DEX 1 mg·kg-1 10 min before anesthesia, and 0.3 mg·(kg·h)-1 intraoperatively until 30 min before the end of surgery. The patients in the control group were given the same amount of normal saline instead of DEX. The incidence of postoperative cognitive dysfunction(POCD) and the plasma miR-206, BDNF levels and adverse reactions at postoperative 1, 3 and 7 days were compared between the two groups. According to the occurrence of POCD at postoperative 7 days, patients were divided into POCD group and non-POCD group. Results: The incidence of POCD in the study group was lower than that in the control group, and on postoperative 1, 3 and 7 days, the plasma BDNF level in the study group was higher than that in the control group, meanwhile, the relative transcript level of plasma miR-206 in the study group was lower than that in the control group(P<0.05). The plasma BDNF level of POCD patients was significantly higher than that of the non-POCD group at postoperative 1, 3 and 7 days(P<0.05), and the relative transcript level of plasma miR-206 was also higher than that of the non-POCD group(P<0.05). The areas under the curve of miR-206 in plasma at postoperative day 1 for predicting the occurrence of POCD at postoperative 3 and 7 days were 0.78(95%CI 0.67-0.84, P<0.001) and 0.82(95%CI 0.71-0.89, P<0.001) respectively. Moreover, miR-206 in plasma at postoperative 1 day >4.10 was an independent risk factor for POCD in elderly colorectal cancer patients at postoperative 7 days(P<0.05). Conclusion: DEX can reduce the risk of POCD in elderly patients under general anesthesia with colorectal cancer surgery, which may be related to the decreased miR-206 expression and increased BDNF level in plasma. |
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