Abstract: Objective To evaluate the reIationship of the serum levels of adiponectin (ADP), matrix metalloproteinase-9(MMP-9) and postoperative cognitive dysfunction (POCD) in elderly patients after general anesthesia. Methods Ninety eight ASA Ⅰ or Ⅱ patients, aged 65 y-83 y, scheduled for artificial hip replacement under general anesthesia were studied. Cognitive functionwas assessed by Montreal Cognitie Assessment(MoCA), at 3 d before the operation and 1, 2, 3 d and 7 d after operation, and venous blood samples were collected for determination of serum ADP and MMP-9 levels at the same time in all patients. Patients were divided into POCD group and non-POCD group according to the occurrence of POCD in 3 d after operation. Results Twenty eight patients developed POCD(28.5%). Compared with the preoperative levels (293±50) μg/L, the serum levels of MMP-9 [(537±68),(481±64),(432±64),(393±48) μg/L] were significantly increased at 1, 2, 3 d and 7 d after operation, and the serum levels of ADP[(4.3±1.6),(4.7±1.2),(5.1±1.6),(6.0±1.1) mg/L] were significantly declined at 1, 2, 3 d and 7 d after operation compared with the preoperative levels(9.39±1.36) μg/L in group POCD(P<0.05). Compared with that of preoperation, the serum levels of MMP-9 were significantly increased, and the serum levels of ADP were significantly declined on 1,2 d in group non-POCD. The serum levels of MMP-9 in group POCD, were significantly higher than that in group non-POCD[(439±53),(387±66),(301±67),(297±54) μg/L](P<0.05) at 1,2,3,7 d after operation. Compared with group POCD, the serum levels of ADP [(5.7±1.0),(6.7±1.4),(9.1±1.0),(9.34±1.2) mg/L] were significanfly higher in group non-POCD(P<0.05) at 1,2,3,7 d after operation. Correlation analysis showed that the serum levels of MMP-9 were negatively correlated with MoCA score(r=-0.833,P<0.01), the serum 1evels of ADP were positively correlated with MoCA score(r=0.513,P<0.01). Conclusions An decreased postoperative serum ADP level and an increased postoperative serum MMP-9 level may be involved in the pathophysiological process of POCD in elderly patients with general anesthesia.
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