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右美托咪定对老年患者术后认知功能障碍影响机制的研究

Study on the mechanism of Dexmedetomidine's effect on postoperative cognitive dysfunction in elderly people.

作者信息

Cai Yuanbin, Yu Fan, Wu Wei, Chen Wurong

机构信息

Department of Anesthesiology, Putuo District Central Hospital, Shanghai, China.

School of Exercise and Health, Shanghai University of Sport, Shanghai, China.

出版信息

Front Physiol. 2025 Mar 12;16:1508661. doi: 10.3389/fphys.2025.1508661. eCollection 2025.

Abstract

Postoperative cognitive dysfunction (POCD) is a common complication among elderly patients following surgical procedures, significantly impairing postoperative recovery and quality of life. The selection and dosage of intraoperative anaesthetic drugs are frequently implicated as contributing factors in the development of POCD. In recent years, dexmedetomidine (DEX), a novel α2-adrenoceptor agonist, has been increasingly utilized in surgical anaesthesia for elderly patients, showing potential as both a preventive and therapeutic agent for POCD. This paper provides a comprehensive review of current research on the mechanisms by which DEX affects POCD in the elderly. Additionally, it explores DEX's mechanisms of action in the context of neuroprotection, anti-inflammation, antioxidative stress, and the regulation of apoptosis, autophagy, and analgesia. The objective is to provide reliable theoretical support and a reference point for the clinical application of DEX in POCD among the elderly, thereby promoting its broader use in clinical practice to improve outcomes and enhance quality of life.

摘要

术后认知功能障碍(POCD)是老年患者术后常见的并发症,严重影响术后恢复和生活质量。术中麻醉药物的选择和剂量常被认为是POCD发生的促成因素。近年来,新型α2肾上腺素能受体激动剂右美托咪定(DEX)越来越多地用于老年患者的手术麻醉,显示出作为POCD预防和治疗药物的潜力。本文全面综述了目前关于DEX影响老年患者POCD机制的研究。此外,还探讨了DEX在神经保护、抗炎、抗氧化应激以及细胞凋亡、自噬和镇痛调节方面的作用机制。目的是为DEX在老年POCD患者中的临床应用提供可靠的理论支持和参考依据,从而促进其在临床实践中的更广泛应用,以改善治疗效果和提高生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4762/11936804/ed80282f2d35/fphys-16-1508661-g001.jpg

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