摘要
术后认知功能障碍(postoperative cognitive dysfunction,POCD)是一种手术麻醉后新发的认知功能减退,严重影响患者术后生存质量。目前关于POCD的病理生理机制尚不明确,但中枢炎症被认为在其中起重要作用。文章对POCD与中枢炎症可能联系的研究进展进行综述:手术麻醉引起全身系统性炎症反应,炎性因子以直接通过血脑屏障(blood brain barrier,BBB)、破坏BBB或激活多种信号通路等方式引发中枢系统炎症;中枢炎症进一步通过炎症消退迟缓、炎症因子直接作用或非炎性介质间接影响等方式作用于患者的认知功能,从而引发POCD;POCD的风险因素也与中枢炎症密切相关;基于POCD中枢炎症机制的干预措施对POCD预防可能有积极意义。
Postoperative cognitive dysfunction(POCD)is a degraded cognitive function after surgical anesthesia,and severely affects the quality of life after surgery.So far,the pathophysiological mechanism is not clear,but central inflammation is considered to be important during the process.This article reviews the progress on the possible connection between POCD and central inflammation.Surgical anesthesia causes systemic inflammatory response in the whole body,while inflammatory factors can lead to inflammation in the central nervous system through direct entry into the blood-brain barrier(BBB),and impairment of the BBB or activation of multiple signaling pathways.Central inflammation affects patients*cognitive function to cause POCD through delayed inflammation resolution,direct action of inflammatory factors or indirect action of non-inflammatory mediators.Meanwhile,the risk factors of POCD are closely related to central inflammation.Interventions based on central neuroinflammation mechanism may have positive effects on the prevention and control of POCD.
作者
戴瑜彤
吴昊
陈颖
顾小萍
夏天娇
Dai Yutong;Wu Hao;Chen Ying;Gu Xiaoping;Xia Tianjiao(Jiangsu Key Laboratory of Molecular Medicine,Nanjing University,Nanjing 210008,China;Department of Anesthesiology,Drum Tower Hospital Affiliated to Nanjing University Medical School,Nanjing 210008,China)
出处
《国际麻醉学与复苏杂志》
CAS
2020年第2期196-199,共4页
International Journal of Anesthesiology and Resuscitation
基金
国家自然科学基金(81730033,81701371)
江苏省自然科学基金(BK20170654)。
关键词
术后认知功能障碍
中枢神经系统
炎症
炎症因子
血脑屏障
Postoperative cognitive dysfunction
Central nervous system
Inflammation
Inflammatory factor
Blood brain barrier
