术后认知功能障碍与中枢炎症之间的可能联系

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。

Possible association between postoperative cognitive dysfunction and central neuroinflammation

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.