Sun Jing, Du Xiaohong, Chen Yong
Department of Anesthesia and Perioperative Medicine, The Second Affiliated Hospital of Nanchang University, 330006 Nanchang, Jiangxi, China.
Jiangxi Province Key of Laboratory of Anesthesiology, 330006 Nanchang, Jiangxi, China.
J Integr Neurosci. 2024 Dec 24;23(12):224. doi: 10.31083/j.jin2312224.
Postoperative cognitive dysfunction (POCD) represents a significant clinical concern, particularly among elderly surgical patients. It is characterized by a decline in cognitive performance, affecting memory, attention, coordination, orientation, verbal fluency, and executive function. This decline in cognitive abilities leads to longer hospital stays and increased mortality. This review provides a comprehensive overview of the current progress in understanding the relevant pathogenic factors, possible pathogenic mechanisms, diagnosing, prevention and treatment of POCD, as well as suggesting future research directions. It discusses neuronal damage, susceptible genes, central cholinergic system, central nervous system (CNS) inflammation, stress response and glucocorticoids, and oxidative stress in the development of POCD, aiming to uncover the pathological mechanism and develop effective treatment strategies for POCD.
术后认知功能障碍(POCD)是一个重大的临床问题,在老年外科患者中尤为突出。其特征是认知能力下降,影响记忆、注意力、协调能力、定向力、语言流畅性和执行功能。认知能力的这种下降会导致住院时间延长和死亡率增加。本综述全面概述了目前在理解POCD的相关致病因素、可能的致病机制、诊断、预防和治疗方面的进展,并提出了未来的研究方向。它讨论了神经元损伤、易感基因、中枢胆碱能系统、中枢神经系统(CNS)炎症、应激反应和糖皮质激素以及氧化应激在POCD发生发展中的作用,旨在揭示其病理机制并制定有效的POCD治疗策略。