Lei Daoyun, Sha Yeqin, Wen Shuang, Xie Songhui, Liu Li, Han Chao
Department of Anesthesiology, The Affiliated Yixing Hospital of Jiangsu University, Yixing, China.
Nanjing Medical University, Jiangsu, China.
Dose Response. 2020 Feb 5;18(1):1559325820902345. doi: 10.1177/1559325820902345. eCollection 2020 Jan-Mar.
Dexmedetomidine (DEX) was widely used in clinical work. However, the effectiveness of DEX on postoperative cognitive dysfunction (POCD) was still need to be confirmed. The aim of this meta-analysis was to explore whether DEX can reduce the incidence of POCD on the first day and seventh postoperative day. The results showed that lower incidence of POCD associated with DEX treatment on the first (odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.31-0.54) or seventh postoperative day (OR: 0.53; 95% CI: 0.36-0.77). Mini-Mental State Examination scores on the first (mean difference [MD]: 4.67; 95% CI: 1.72-7.63) and seventh postoperative days (MD: 3.71; 95% CI: 2.51-4.90) were higher in DEX use group than that in physiological saline group. Meanwhile, neuron-specific enolase (NSE; MD: -3.99; 95% CI: -6.20 to -1.78) and interleukin 6 (IL-6) levels (MD: -17.53; 95% CI: -21.51 to -13.54) on the first postoperative day in DEX group were lower than that in the physiological saline group. This meta-analysis suggested that DEX use could reduce the risk of POCD and the reduction in levels of NSE and IL-6 can improve long-term cognitive dysfunction and anti-inflammation.
右美托咪定（DEX）在临床工作中被广泛应用。然而，DEX对术后认知功能障碍（POCD）的有效性仍有待证实。本荟萃分析的目的是探讨DEX是否能降低术后第一天和第七天POCD的发生率。结果显示，在术后第一天（比值比[OR]：0.41；95%置信区间[CI]：0.31 - 0.54）或第七天（OR：0.53；95% CI：0.36 - 0.77），DEX治疗与较低的POCD发生率相关。在术后第一天（平均差[MD]：4.67；95% CI：1.72 - 7.63）和第七天（MD：3.71；95% CI：2.51 - 4.90），使用DEX组的简易精神状态检查表得分高于生理盐水组。同时，DEX组术后第一天的神经元特异性烯醇化酶（NSE；MD： - 3.99；95% CI： - 6.20至 - 1.78）和白细胞介素6（IL - 6）水平（MD： - 17.53；95% CI： - 21.51至 - 13.54）低于生理盐水组。本荟萃分析表明，使用DEX可降低POCD风险，NSE和IL - 6水平的降低可改善长期认知功能障碍并具有抗炎作用。
