Objective: To evaluate the effect of serum homocysteine (Hcy) level on post-operative cognitive dysfunction (POCD) in elderly patients with hip arthroplasty. Methods: 100 elderly patients with hip joint replacement by the combined spinal epidural anesthesia were selected, male or female, aged from 65 to 81, ASA class Ⅱ or Ⅲ.According to plasma Hcy concentration, they were divided into three groups:group A Hcy < 10 μmol·L-1(n=42), group B 10 ≤ Hcy < 20μmol·L-1(n=36) and group C Hcy ≥ 20 μmol·L-1(n=22). The mimi-mental state examination(MMSE) was used to assess the cognitive function at 1d preoperation(T0)and 24h(T1), 72h(T2), 7d(T3) after the operation. Results: Compared with T0, the MMSE scores were decreased at T1-T3 time point in group B, C and T1, T2 time point in group A (P<0.05 or 0.01); Compared with group A,MMSE scores were decreased at T1-T3 in group B, C(P<0.05 or 0.01); Compared with group B,MMSE scores were decreased at T1-T3 in group C (P<0.05 or 0.01); The incidence of POCD from high to low was group C,group B, and group A in turn(P<0.05 or 0.01). Conclusion: Serum Hcy levels can affect cognitive function in elderly patients with hip arthroplasty. The incidence of POCD is positively correlated with serum Hcy concentration.
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