胞磷胆碱钠对老年腹腔镜术患者术后认知功能的影响研究

Study on the Effect of Citicoline Sodium on Postoperative Cognitive Function in Elderly Patients Undergoing Laparoscopic Surgery

摘要: 目的：探究胞磷胆碱钠对老年腹腔镜术患者术后认知功能的影响，并剖析其可能的作用机制。方法：选取2023年6月~2025年6月我院老年腹腔镜术患者72例，随机分两组，胞磷胆碱组术前20分钟静脉滴注0.5 g胞磷胆碱钠(250 mL生理盐水稀释，30分钟内滴完)，对照组滴注等量生理盐水。于术前1天及术后1、3、5天及术后1个月检测MMSE评分、血清S100β及IL-6水平，记录术后认知功能障碍(POCD)发生率。结果：术前两组各项指标无统计学差异(p > 0.05)；术后1天、3天两组MMSE评分均下降，血清S100β、IL-6水平均升高(p < 0.05)；胞磷胆碱组术后各时间点MMSE评分高于对照组，血清S100β、IL-6水平及POCD发生率低于对照组(p < 0.05)。术后1个月时，胞磷胆碱组未出现POCD，对照组仍有2例POCD发生。结论：胞磷胆碱钠可有效改善老年腹腔镜术患者术后认知功能、降低POCD发生率，机制可能与抑制神经炎症、减轻神经损伤相关。

Abstract: Objective: To investigate the effect of citicoline sodium on postoperative cognitive function in elderly patients undergoing laparoscopic surgery and to analyze its potential mechanism of action. Method: A total of 72 elderly patients who underwent laparoscopic surgery in our hospital from June 2023 to June 2025 were enrolled and randomly divided into a citicoline sodium group and a control group. Patients in the citicoline sodium group received an intravenous infusion of 0.5 g citicoline sodium 20 min before anesthesia induction (diluted in 250 mL normal saline and infused within 30 min), while patients in the control group received an equal volume of normal saline. Mini-Mental State Examination (MMSE) scores, serum S100β and interleukin-6 (IL-6) levels were assessed 1 day before surgery, and at 1 day, 3 days, 5 days, and 1 month after surgery. The incidence of postoperative cognitive dysfunction (POCD) was also recorded. Result: There were no significant differences in baseline indicators between the two groups before surgery (p > 0.05). At 1 day and 3 days after surgery, MMSE scores decreased while serum S100β and IL-6 levels increased significantly in both groups (p < 0.05). Compared with the control group, the citicoline sodium group showed significantly higher MMSE scores and significantly lower serum S100β levels, IL-6 levels, and incidence of POCD at all postoperative time points (p < 0.05). At 1 month after surgery, no POCD was observed in the citicoline sodium group, whereas 2 cases of POCD remained in the control group. Conclusion: Citicoline sodium can effectively improve postoperative cognitive function and reduce the incidence of POCD in elderly patients undergoing laparoscopic surgery. The underlying mechanisms may be related to the inhibition of neuroinflammation and alleviation of neuronal injury.