术后认知功能障碍的炎症机制

背景 术后认知功能障碍(postoperative cognitive dysfunction,POCD)是老年患者手术后常见的中枢神经系统并发症.目前POCD的发病机制尚不清楚.POCD的发生影响了患者术后恢复,延长了住院时间,增加了术后并发症的发生率和死亡率;对家庭及社会造成严重的经济负担,POCD将成为一个严重的社会问题.目的 旨在推进POCD的研究,使得这一严重问题得到解决.内容 以往的研究表明,麻醉、手术可能是的POCD主要原因,而老龄则是惟一明确的危险应素,提示中枢神经系统退行性改变与POCD的发生可能有着重要联系,而麻醉和手术加重了这种退行性改变所致的认知功能衰退.趋向 较多研究表明炎症反应在与衰老有关的认知功能减退中起着重要作用,而手术创伤和应激引起的炎症反应是围术期发生的重要病理生理学改变.近年来炎症反应在POCD发生中的作用备受关注,现对POCD发生中炎症反应方面的研究进展进行综述.

Inflammation: a possible mechanism of postoperative cognitive dysfunction

Background Postoperative cognitive dysfunction (POCD) is a common central nervous system complication in elderly patients. At present, the pathogenesis of POCD remains unclear. The occurrence of POCD may affect the postoperative recovery of patients, prolonged hospital stays, increase the incidence of postoperative complications and mortality,and impose additional financial burdens on on the family and society. POCD will become a serious social problem. Purpose To promote POCD research, striving for an early resolution of this serious problem. Content Previous studies have shown that anesthesiaand surgery might be the major causes of POCD, and aging is the only clear risk factor of it, suggesting that degenerative changes in the central nervous system is a correlative factor of the occurrence of POCD and anesthesia and surgery may aggravate the POCD derived from such degenerative changes. Trend It is reported that age-related inflammation in cognitive dysfunction plays an important role,and inflammation caused by surgical trauma and stress is an important perioperative pathophysiological change. In recent years, the role of inflammation in POCD has drawn a particular attention. This paper is tomake a review of the new development of the research of inflammation in POCD.