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围手术期神经认知障碍的炎症机制及治疗进展
徐艳
陈婵
姜春玲
薄禄龙
作者及单位信息
·
DOI： 10.3760/cma.j.issn.2095-4352.2019.12.028
Role of inflammation in perioperative neurocognitive disorders and its therapeutic implication
Xu Yan
Chen Chan
Jiang Chunling
Bo Lulong
Authors Info & Affiliations
Xu Yan
Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
Chen Chan
Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
Jiang Chunling
Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
Bo Lulong
Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
·
DOI： 10.3760/cma.j.issn.2095-4352.2019.12.028
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摘要

围手术期神经认知障碍（PND）是术后常见的并发症之一，多见于老年患者。PND的发生不仅影响患者生活质量，增加医疗负担，还会导致患者术后病残率和病死率升高。有研究表明，中枢神经系统的炎症反应导致了PND的发生，但PND的发病机制尚不清楚。本文就神经炎症反应和免疫细胞激活在PND发生发展中的作用进行综述，并介绍根据作用靶点提出的潜在治疗方法，以期为相关研究和临床决策提供参考。

围手术期神经认知障碍;炎症反应;免疫细胞;治疗药物
ABSTRACT

Perioperative neurocognitive disorder (PND) is one of the most common complications after operations in elderly patients. Occurrence of PND not only affects the quality of life but also increases the burden of medical care, as well as the post-operation disability and mortality rate. Previous studies have shown that the inflammatory response in central nervous system can lead to PND, however, its pathogenesis is undetermined. In this work, the role of neuro-inflammatory response and immune cell activation in the development of PND is reviewed, and the potential treatment is introduced, in order to provide insight for future research and clinical decision.

Perioperative neurocognitive disorder;Inflammation response;Immune cell;Therapeutic drug
Jiang Chunling, Email: nc.defudabe.ucsgnilnuhcgnaij
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引用本文

徐艳,陈婵,姜春玲,等. 围手术期神经认知障碍的炎症机制及治疗进展[J]. 中华危重病急救医学,2019,31(12)：1559-1562.

DOI:10.3760/cma.j.issn.2095-4352.2019.12.028

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围手术期神经认知障碍（PND）是手术麻醉后一种常见的中枢神经系统并发症。2018年6月，美国术后认知研究协作组推荐采用"围手术期神经认知障碍"这一新术语，取代既往使用的"术后认知功能障碍"（POCD）来描述患者围手术期认知功能的改变，以促进不同医学专业间的交流 [ 1 ]。PND可于术后数天至数月出现，持续时间长短不一，主要表现为注意力、学习力、记忆力、执行力及语言表达能力等较术前水平下降。有研究显示，患者术后7 d时PND发生率为17%～43%，术后3个月时PND发生率约为17% [ 2 ]。随着人口老龄化进程以及老年患者手术量的增加，PND发生率亦将增加。然而PND的确切发病机制尚不明确。现着重就神经炎症反应和免疫细胞激活在PND发生发展中的作用予以综述，并介绍根据作用靶点提出的潜在治疗方法，以期为相关研究和临床决策提供参考。
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备注信息
A
姜春玲，Email： nc.defudabe.ucsgnilnuhcgnaij
B
所有作者均声明不存在利益冲突
C
国家自然科学基金 (81870858)
上海市卫生系统优秀人才培养计划项目 (2017YQ015)
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