Wang Xiao-Qing, Li He, Li Xiang-Nan, Yuan Cong-Hu, Zhao Hang
Department of Anesthesiology, School of Medicine, Affiliated Yancheng Hospital, Southeast University, Yancheng, China.
Department of Anesthesiology, Affiliated Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Front Aging Neurosci. 2021 Dec 22;13:745774. doi: 10.3389/fnagi.2021.745774. eCollection 2021.
Aging is becoming a severe social phenomenon globally, and the improvements in health care and increased health awareness among the elderly have led to a dramatic increase in the number of surgical procedures. Because of the degenerative changes in the brain structure and function in the elderly, the incidence of perioperative neurocognitive disorders (PND) is much higher in elderly patients than in young people following anesthesia/surgery. PND is attracting more and more attention, though the exact mechanisms remain unknown. A growing body of evidence has shown that the gut microbiota is likely involved. Recent studies have indicated that the gut microbiota may affect postoperative cognitive function via the gut-brain axis. Nonetheless, understanding of the mechanistic associations between the gut microbiota and the brain during PND progression remains very limited. In this review, we begin by providing an overview of the latest progress concerning the gut-brain axis and PND, and then we summarize the influence of perioperative factors on the gut microbiota. Next, we review the literature on the relationship between gut microbiota and PND and discuss how gut microbiota affects cognitive function during the perioperative period. Finally, we explore effective early interventions for PND to provide new ideas for related clinical research.
老龄化正在成为全球范围内一个严峻的社会现象，而医疗保健的改善以及老年人健康意识的提高导致外科手术数量急剧增加。由于老年人脑结构和功能的退行性变化，老年患者围手术期神经认知障碍（PND）的发生率在麻醉/手术后比年轻人高得多。PND正受到越来越多的关注，尽管确切机制尚不清楚。越来越多的证据表明肠道微生物群可能与此有关。最近的研究表明，肠道微生物群可能通过肠-脑轴影响术后认知功能。然而，对于PND进展过程中肠道微生物群与大脑之间的机制关联的理解仍然非常有限。在这篇综述中，我们首先概述关于肠-脑轴和PND的最新进展，然后总结围手术期因素对肠道微生物群的影响。接下来，我们回顾关于肠道微生物群与PND之间关系的文献，并讨论肠道微生物群在围手术期如何影响认知功能。最后，我们探索PND的有效早期干预措施，为相关临床研究提供新思路。
