Abstract: Objective　To analyze the effect of preoperative hyperbaric oxygen treatment on the serum levels of Tau, phosphorylated Tau (pTau), and β-amyloid 1-42 (Aβ1-42) proteins in patiets after coronary artery bypass grafting. Methods　From January to December 2019, 80 patients who underwent coronary artery bypass grafting in The First Affiliated Hospital of Nanyang Medical College were selected and divided into a control group and an observation group by the random number table method, with 40 cases in each group. There were 27 males and 13 females in the control group, and they were (53.01±8.16) years old. There were 24 males and 16 females in the observation group, and they were (54.51±7.90) years old. The control group took conventional preoperative treatment; in addition, the observation group took hyperbaric oxygen treatment. The serum levels of Tau, pTau, and Aβ1-42 were detected by enzyme-linked immunosorbent assay 1 week after the surgery. The levels of postoperative cognitive function and incidences of postoperative cognitive dysfunction were compared between the two groups according to Montreal Cognitive Assessment Scale (MoCA). The adverse reactions in the two groups were recorded. The measurement data were compared between the two groups by independent-sample t test, and the enumeration data by χ² test. Results　One week after the operation, the levels of Tau and pTau in the observation group were lower than those in the control group (t=5.690 and 7.054; both P<0.001), and the level of Aβ1-42 in the observation group was higher than that in the control group (t=10.300, P<0.001). After the operation, the total score and dimension scores of MoCA in the observation group were higher than those in the control group (t=4.776, 3.688, 2.860, 6.870, 4.308, 2.611, 5.908, and 4.567; all P<0.05). The incidence of cognitive dysfunction in the observation group was significantly lower than that in the control group [12.50% (5/40) vs. 32.50% (13/40)], with a statistical difference (χ²=4.588, P=0.032). There was no significant difference in the incidence of adverse reactions between the two groups (χ²=0.125, P=0.723). Conclusion　Preoperative hyperbaric oxygen treatment can alleviate the abnormal changes of serum levels of Tau, pTau, and Aβ1-42 in patients after coronary artery bypass grafting, improve their postoperative cognitive function, and reduce the incidence of cognitive dysfunction, and is safe.

Key words: Hyperbaric oxygen, Coronary artery bypass grafting, Tau protein, Phosphorylated Tau protein, Beta-amyloid 1-42, Cognitive dysfunction

摘要： 目的　分析术前高压氧处理对冠状动脉搭桥术患者术后血清Tau蛋白、磷酸化Tau蛋白（pTau）及β-淀粉样蛋白1-42（Aβ1-42）水平的影响。方法　选取2019年1月至12月南阳医学高等专科学校第一附属医院接收的80例预行冠状动脉搭桥术患者，依据简单随机数字表法分为对照组和观察组，各40例。对照组男27例、女13例，年龄（53.01±8.16）岁；观察组男24例、女16例，年龄（54.51±7.90）岁。对照组给予常规术前处理，观察组在此基础上给予高压氧处理措施。术后1周采用酶联免疫吸附法检测两组患者血清Tau、pTau及Aβ1-42水平，依据蒙特利尔认知评估量表（MoCA）比较两组术后认知功能水平、术后认知功能障碍发生率，并记录两组不良反应发生情况。计量资料组间比较采用独立样本t检验，组内比较采用配对t检验，计数资料组间比较采用χ²检验。结果　术后1周，观察组Tau、pTau水平低于对照组，Aβ1-42水平高于对照组（t=5.690、7.054、10.300，均P<0.001）；术后，观察组MoCA总分及各维度评分均高于对照组（t=4.776，3.688、2.860、6.870、4.308、2.611、5.908、4.567，均P<0.05）；观察组术后认知功能障碍的发生率明显低于对照组［12.5%（5/40）比 32.5%（13/40）］，两组比较差异有统计学意义（χ²=4.588，P=0.032）；两组不良反应比较差异无统计学意义（χ²=0.125，P=0.723）。结论　术前高压氧处理能够减轻冠状动脉搭桥术后血清Tau、pTau、Aβ1-42水平异常变化，改善患者术后认知功能，降低认知功能障碍的发生率，且安全性较高。

关键词: 高压氧, 冠状动脉搭桥术, Tau蛋白, 磷酸化Tau蛋白, β-淀粉样蛋白1-42, 认知功能障碍