焦虑情绪对老年食管癌患者围手术期血清MPO、 LXA4 水平及血管内皮功能的影响

Effect of perioperative anxiety on serum levels of MPO, LXA4 and vascular endothelial function for elderly patients with esophageal cancer

摘要:

目的 探讨老年食管癌患者合并焦虑情绪对围手术期血清髓过氧化物酶（MPO）、血清脂氧素A4 （LXA4）水平及血管内皮功能的影响。方法 选取2015 年10 月-2016 年10 月该院所收治的60 例老年食管癌 合并焦虑情绪患者作为研究对象，并将其随机分为观察组和对照组，每组各30 例。两组均行食管癌根治性手术 治疗，观察组在手术治疗基础上加抗焦虑干预治疗。比较和分析两组焦虑情绪、血清MPO、血清LXA4 及血 管内皮功能变化情况；治疗后6 个月预后情况和观察组治疗后不同焦虑自评量表评分（SAS）与血清MPO、 LXA4 水平及血管内皮功能变化情况。结果 两组治疗后SAS 比较有差异（P <0.05），观察组SAS 低于对照组； 两组治疗后血清MPO 比较有差异（P <0.05），观察组血清MPO 低于对照组；两组治疗后血清LXA4 比较有 差异（P <0.05），观察组血清LXA4 低于对照组；两组治疗后内皮素（ET）比较有差异（P <0.05），观察组低 于对照组；两组治疗后一氧化氮（NO）、血管扩张率（FMD）及动脉内径变化率（GTN）比较有差异（P <0.05）， 观察组高于对照组；观察组治疗后不同SAS 评分与血清MPO、LXA4 水平及血管内皮功能指标变化情况比 较有差异（P <0.05）；两组治疗后6 个月预后情况比较有差异（P <0.05），观察组预后情况优于对照组（P <0.05）。 结论 抗焦虑干预治疗能有效消除老年食管癌患者合并焦虑的负性情绪，改善患者围手术期血清MPO、LXA4 水平及血管内皮功能，可作为理想的辅助治疗方案在临床应用和推广。

Abstract:

Objective To investigate the effect of perioperative anxiety on serum MPO, LXA4 and vascular endothelial function for elderly patients with esophageal cancer. Methods Totally 60 elderly patients with esophageal cancer combined anxiety admitted into our hospital from October 2015 to October 2016 were involved in this study. Patients were randomly divided into observation group and control group (n = 30). All patients received standard radical surgery. Additional anti-anxiety therapy was introduced in observation group. The changes of anxiety, serum levels of MPO, LXA4, vascular endothelial function, and the prognosis of 6 monthspre andpost treatment were recorded. Results Patients in observation group experienced significantly decreased levels of SAS score, MPO, LXA4 and ET when compared with control group (P < 0.05), while concentrations of NO, FMD and GTN were increased significantly in observation group when compared with that in control group (P < 0.05). Treatment of anxiety induced dramatically decrease of SAS score, MPO and LXA4 as well as improved prognosis when compared with that prior to any anti-anxiety intervention. Conclusions Anti-anxiety intervention eliminates perioperatively negative emotions and improve prognosis of elderly patients with esophageal cancer combined with anxiety.