轻度认知障碍会增加术后发生认知功能障碍的风险吗？
Does mild cognitive impairment increase the risk of developing postoperative cognitive dysfunction?
作者信息
Bekker Alex, Lee Cynthia, de Santi Susan, Pirraglia Elizabeth, Zaslavsky Alexander, Farber Sonya, Haile Michael, de Leon Mony J
机构信息
Department of Anesthesiology, New York University Medical Center, New York, NY, USA.
出版信息
Am J Surg. 2010 Jun;199(6):782-8. doi: 10.1016/j.amjsurg.2009.07.042.
BACKGROUND
Increasingly, postoperative cognitive dysfunction (POCD) is recognized as a complication after surgery in the elderly. We sought to determine whether patients with mild cognitive impairment (MCI) would have an accelerated progression of dementia postoperatively when compared with the patients without MCI.
METHODS
The Center for Brain Health at the New York University (NYU) Medical Center maintains records of volunteers who undergo a series of neurological assessments. We reviewed records of 670 patients who received at least 2 evaluations and whose surgery occurred before the second assessment. Longitudinal differences of several cognitive domains were examined.
RESULTS
Individuals with MCI and surgery had a greater decline in performance on the Digit Span Forward test compared with those with MCI without surgery on their postoperative evaluation (F(3,158) = 3.12, P = .03). No performance changes were detected in the normal subjects.
CONCLUSION
These preliminary findings suggest that surgery negatively impacts attention/concentration in patients with MCI but not in normal individuals. This is the first study that identified a specific subgroup of patients who are predisposed to POCD.
背景
术后认知功能障碍（POCD）越来越被认为是老年人手术后的一种并发症。我们试图确定与无轻度认知障碍（MCI）的患者相比，患有MCI的患者术后痴呆进展是否会加速。
方法
纽约大学（NYU）医学中心的脑健康中心保存着接受一系列神经学评估的志愿者记录。我们回顾了670例接受至少2次评估且手术在第二次评估之前进行的患者记录。检查了几个认知领域的纵向差异。
结果
与术后未接受手术的MCI患者相比，接受手术的MCI患者在顺背数字广度测试中的表现下降更大（F(3,158) = 3.12，P = .03）。在正常受试者中未检测到表现变化。
结论
这些初步发现表明，手术对MCI患者的注意力/专注力有负面影响，但对正常个体没有影响。这是第一项确定易患POCD的特定患者亚组的研究。
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