Liu Yang, Yang Wei, Xue Jinqi, Chen Juntong, Liu Shiqing, Zhang Shijie, Zhang Xiaohui, Gu Xi, Dong Youjing, Qiu Peng
Department of Oncology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning province, China.
Department of Infectious Disease, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning province, China.
Biomed Pharmacother. 2023 Nov;167:115582. doi: 10.1016/j.biopha.2023.115582. Epub 2023 Sep 23.
The proportion of advanced age patients undergoing surgical procedures is on the rise owing to advancements in surgical and anesthesia technologies as well as an overall aging population. As a complication of anesthesia and surgery, older patients frequently suffer from postoperative cognitive dysfunction (POCD), which may persist for weeks, months or even longer. POCD is a complex pathological process involving multiple pathogenic factors, and its mechanism is yet unclear. Potential theories include inflammation, deposition of pathogenic proteins, imbalance of neurotransmitters, and chronic stress. The identification, prevention, and treatment of POCD are still in the exploratory stages owing to the absence of standardized diagnostic criteria. Undoubtedly, comprehending the development of POCD remains crucial in overcoming the illness. Neuroinflammation is the leading hypothesis and a crucial component of the pathological network of POCD and may have complex interactions with other mechanisms. In this review, we discuss the possible ways in which surgery and anesthesia cause neuroinflammation and investigate the connection between neuroinflammation and the development of POCD. Understanding these mechanisms may likely ensure that future treatment options of POCD are more effective.
由于外科手术和麻醉技术的进步以及人口的整体老龄化，接受外科手术的老年患者比例正在上升。作为麻醉和手术的一种并发症，老年患者经常遭受术后认知功能障碍（POCD），这种情况可能会持续数周、数月甚至更长时间。POCD是一个涉及多种致病因素的复杂病理过程，其机制尚不清楚。潜在的理论包括炎症、致病蛋白沉积、神经递质失衡和慢性应激。由于缺乏标准化的诊断标准，POCD的识别、预防和治疗仍处于探索阶段。毫无疑问，了解POCD的发展对于战胜这种疾病仍然至关重要。神经炎症是主要的假说，也是POCD病理网络的关键组成部分，并且可能与其他机制有复杂的相互作用。在这篇综述中，我们讨论了手术和麻醉引起神经炎症的可能方式，并研究了神经炎症与POCD发展之间的联系。了解这些机制可能会确保未来POCD的治疗选择更加有效。
