Polimorfizam APOE gena kao potencijalni prediktor postoperativne kognitivne disfunkcije u operaciji raka debelog creva u opštoj anesteziji
Sažetak
Uvod/Cilj. Postoperativni kognitivni poremećaj (postoperative cognitive dysfunction – POCD) se veoma često javlja kod operisanih bolesnika. Ta, sve češća komplikacija, negativno utiče na oporavak operisanih bolesnika, narušava kvalitet života kako bolesnika tako i njihovih porodica, produžava dužinu hospitalizacije i uvećava troškove lečenja. Cilj rada bio je da se ispita povezanost ε4 alela apolipoproteina E (APOE), sociodemografskih i kliničkih karakteristika sa pojavom POCD sedam dana i tri meseca posle operacije karcinoma debelog creva (KDC) u opštoj anesteziji (OA). Metode. U istraživanju je učestvovalo 113 bolesnika starosne dobi od 18 do 87 godina koji su bili podvrgnuti operaciji KDC u OA u periodu od 2021. do 2023. godine. Preoperativna priprema, anestezija i postoperativno lečenje bili su ujednačeni i standardizovani kod svih bolesnika. Procena kognitivnog statusa urađena je na osnovu psihometrijskog testa Mini Mental State Examination jedan dan pre operacije, sedmog postoperativnog dana i tri meseca posle operacije. Rezultati. Sedam dana posle operacije, utvrđen je statistički značajan poremećaj kognitivnih funkcija kod bolesnika koji su u svom genotipu imali ε4 alel APOE (p = 0,007). Bolesnici od 65 godina i stariji češće su imali POCD tri meseca posle operacije u poređenju sa mlađim bolesnicima (80,0% vs. 52,9%; p < 0,003). Zaključak. Prisustvo ε4 alela APOE predstavlja potencijalni prediktor nastanka POCD sedam dana posle operacije, a godine starosti predstavljaju značajan sociodemografski faktor nastanka POCD tri meseca posle operacije KDC u OA.
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