Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.
J Clin Neurophysiol. 2013 Oct;30(5):435-7. doi: 10.1097/WNP.0b013e3182a73e04.
Effective development of targeted therapies to prevent and treat delirium requires an understanding of the underlying physiologic processes. Historically, delirium has been considered a reflection of diffuse cerebral metabolic insufficiency, which may be a result of some combination of abnormal blood flow, abnormal energy metabolism, abnormal neurotransmission, and abnormal cellular maintenance processes. Perspectives on the pathophysiology underlying hepatic encephalopathy, sepsis-associated encephalopathy, critical illness delirium, and alcohol withdrawal delirium are discussed. Given the diverse etiologic mechanisms, it is likely that the pathophysiology underlying delirium is also quite diverse. Additional investigation is required to identify therapeutic targets for prevention and treatment.
有效开发靶向治疗以预防和治疗谵妄需要了解潜在的生理过程。从历史上看，谵妄被认为是弥漫性脑代谢不足的反映，这可能是异常血流、异常能量代谢、异常神经传递和异常细胞维持过程的某种组合的结果。讨论了肝性脑病、脓毒症相关脑病、危重病性谵妄和酒精戒断性谵妄的潜在病理生理学观点。鉴于不同的发病机制，谵妄的潜在病理生理学也可能非常多样化。需要进一步研究以确定预防和治疗的治疗靶点。
