依达拉奉是一种脑保护剂（自由基清除剂）。机理研究提示，依达拉奉可清除自由基，抑制脂质过氧化，从而抑制脑细胞、血管内皮细胞、神经细胞的氧化损伤。临床上用于改善急性脑梗塞所致的神经症状、日常生活活动能力和功能障碍。而术后认知功能障碍（POCD）的潜在发病机制包括炎症、神经退行性变、神经递质异常等。目前对POCD的防治依然缺乏有效的手段，依达拉奉是否可以起到明显的作用呢？让我们看看这篇发表在Int J Surg的随机对照研究的结果如何吧。
摘要译文
依达拉奉对老年髋关节置换术后认知功能的影响：一项随机对照试验
背景：术后认知功能障碍（POCD）是患者术后中枢神经系统的并发症。依达拉奉作为脑保护剂可能对术后认知功能有保护作用。本研究旨在探讨依达拉奉对老年髋关节置换术后认知功能的影响及其可能机制。
方法：将行髋关节置换术的患者随机分为依达拉奉组（E组）和对照组（C组）。麻醉诱导后E组静注依达拉奉0.5mg/kg，C组静注生理盐水。术前1天、术后第3天、术后第7天用简易精神状态检查（MMSE）评定认知功能。分别于麻醉诱导前、手术结束时、术后第3天检测患者血浆S100β蛋白（S100β）、白细胞介素6（IL-6）、基质金属蛋白酶9（MMP-9）、超氧化物歧化酶（SOD）和丙二醛（MDA）水平。
结果：术后第3d，E组MMSE评分高于C组（25.98±1.99 vs 24.86±1.86，p=0.003）。两组术后及术后第3天血浆IL-6、S100β、MMP-9水平均显著升高（p 0.05），而依达拉奉预处理能在一定程度上降低血浆IL-6、S100β、MMP-9水平（p 0.05），术后第3天超氧化物歧化酶（SOD）水平低于C组（7.01±2.37nmol/ml vs 11.34±3.18nmol/ml，p=0.0001）。
结论：术前应用依达拉奉可改善老年患者髋关节置换术后认知功能。
关键词：依达拉奉；老年人；髋关节置换术；术后认知功能障碍。
原文摘要
Effects of Edaravone on Postoperative Cognitive Function in Elderly Patients Undergoing Hip Joint Replacement Surgery: A Randomized Controlled Trial
Background: Postoperative cognitive dysfunction (POCD) is a complication of central nervous system in patients after surgery. Edaravone as a brain-protective agent may have protective effect on postoperative cognitive function. The study was designed to explore the effects of edaravone on postoperative cognitive function in eldely patients undergoing hip joint replacement surgery and potential mechanism.
Patients and methods: Patients undergoing hip joint replacement surgery were randomly allocated into 2 groups: the edaravone group (group E) and the control group (group C). Group E received intravenous edaravone at a dose of 0.5mg/kg after induction of anesthesia, while group C received normal saline. The cognitive function was evaluated with the Mini-Mental State Examination (MMSE) 1day before surgery,3 days and the 7 days after surgery. Patients plasma samples were collected to detect the levels of S100β protein (S100β), interleukin-6 (IL-6), matrix metalloproteinase-9 (MMP-9), superoxide dismutase (SOD) and malondialdehyde (MDA) before the induction of anesthesia, at the end of surgery and on postoperative day 3.
Results: The MMSE scores in group E were higher than those of group C 3 days after surgery (25.98±1.99 vs 24.86±1.86, p = 0.003). There were remarkable rises (p 0.05) in plasma IL-6, S100βand MMP-9 levels at the end of surgery and on postoperative day 3 in the two groups, however, edaravone pretreatment could reduce these levels to a certain extent compared with group C (p 0.05).In group E, the SOD concentration was higher at the end of surgery (16.03±2.46U/ml vs. 13.65±2.53U/ml, p = 0.0001), while the MDA level was lower on postoperative day 3 than those in group C (7.01±2.37nmol/ml vs. 11.34±3.18nmol/ml, p = 0.0001).
Conclusion: The results indicated that preoperative intervention with edaravone may improve the postoperative cognitive function in elderly patients undergoing hip joint replacement surgery.
Keywords: Edaravone; Elderly; Hip joint replacement; Postoperative cognitive dysfunction.
